摘要
目的探讨代谢综合征（MS）危险因素在老年血管性痴呆（VD）患者中的分布与聚集状况。方法对123例首次发病的年龄≥60岁的脑血管病患者，根据简易精神智力量表（MMSE）和美国精神病学第4版精神病的诊断和统计手册（DSM—Ⅳ）痴呆诊断标准确诊为VD者40例（VD组）；根据头颅CT检查结果选择脑卒中部位、性质与之相匹配的非痴呆的脑血管病患者40例作为对照组（非VD）；另自门诊和住院一般疗养的老年人中选择40例作为健康对照组。分别检测其体质指数（BMI）、血压、血脂、空腹血糖（FPG）、餐后2h血糖（2hPBG）、糖化血红蛋白、胰岛素等指标。结果收缩压、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、2hPBG、胰岛素抵抗指数（HOMA—IR）在对照组、非VD组、VD组依次呈增高趋势，差异有统计学意义（P〈0．05或P＜0．01），高密度脂蛋白胆固醇（HDL-C）则呈下降趋势。收缩压、2hPBG、HOMA-IR在VD组与对照组比较，差异有统计学意义（P〈0．01），VD组MS患病率（57．5％）和危险因素个数（5个危险因素发生率为12．5％）均明显高于对照组（分别为17．5％和2．5％，P＜0．01）。结论 老年VD患者存在更严重的代谢紊乱，早期干预将有助于延缓和减少痴呆的发生、发展。
Objective To investigate the distribution and the aggregation status of the risk factors of metabolic syndrome in the elderly with vascular dementia（VD）, in order to provide the basis of early intervention for elderly VD. Methods Among 123 elderly cases（≥60 yrs） with firstepisode of cerebrovascular disease, 40 cases of VD were confirmed by diagnostic criteria of mini-mental state examination （MMSE） and by diagnostic ＆ statistical manua（DSM）-Ⅳ. By the head CT report, 40 non-dementia elderly patients with cerebrovascular disease （NVD group） were selected, the cerebral apoplectic position matched with those of VD group properly. And from the in-and-outpatients, 40 elderly patients were selected as the healthy control group. The index of body mass index （BMI）, blood pressure, the levels of blood lipids, fasting plasma glucose, 2-hour plasma glucose （2 hPBG）, glycosylated hemoglobin, insulin were detected. Results The systolic blood pressure （SBP）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, 2 hPBG levels and insulin resistance （HOMA-IR） sequentially presented elevating trends in the control group, NVD and VD groups. There were significant differences in the parameters among the groups （P〈0. 05, P〈0. 01） . The high density lipoprotein cholesterol （HDL-C） presented a descending trend. SBP, 2 hPBG and HOMA-IR in VD group were significantly different from those in control group （all P〈0. 01）. The incidence of the metabolic syndrome and the number of the risk factors were both significantly higher in VD group than in control group （all P〈0. 01）. Conclusions Elderly patients with VD have more serious metabolism disorder.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2008年第3期161-163,共3页
Chinese Journal of Geriatrics
基金
浙江省绍兴市市级科研基金（2006A33012）
