摘要
目的:通过心理测查和单光子发射型计算机断层显像(SPECT)等手段,了解型糖尿病患者的认知功能水平及相关因素。方法:40至60岁,性别、文化程度、职业相匹配的NIDDM患者和对照组各30名,排除可能影响认知功能的各种神经和精神疾病、内分泌疾病、药物和酒精滥用者,糖尿病人需排除曾有严重低血糖发作和酮症酸中毒者。做韦氏记忆量表、连线测验和威斯康星卡片分类测验,测查人格和情绪状况,并为志愿者作脑血流灌注显像检查。结果:糖尿病组认知测验成绩均低于对照组,有显著性差异。NIDDM患者认知功能不但与糖尿病并发症、病期、血脂浓度等躯体因素相关,还和患者人格的“精神质”和“情绪性”、健康自评等心理因素有关,“精神质”和“情绪性”越强,健康自评越差,认知障碍就越严重。NIDDM患者的焦虑和抑郁程度比非糖尿病患者重。SPECT显示患者存在局部脑血流灌注的减低,认知功能与额叶、颞叶等脑皮层血流灌注有密切关系。结论:型糖尿病患者存在着记忆力减退、注意力不集中,以及思维不灵活、分类概括能力降低等认知能力的下降,且与躯体和心理因素有关。认知功能下降的直接原因可能是额叶等局部脑血流灌注减低,使相应脑功能受到抑制。
Objective:to examine the cognitive function and related factors in patients with type Ⅱ diabetes by psychological tests and single photon emission computed tomography(SPECT).Method:to enroll 30 NIDDM patients and 30 normal controls with similar demographic characteristics.Patients with hypoglycemia or ketonic acidosis were screened out.Some diseases,which might influence cognitive functions,were excluded,such as cerebrovascular diseases,endocrinoloogical diseases,alcohol and drug abuse,dementia and psychosis.Wechsler Memory Scale Revised(WMS-R),Trail Making Test A and Wisconsin Card Sorting Task(WCST)were administered to both groups.The personality and affective states were also assessed.Brain blood perfusion of 11 patients and 11 control were evaluated by SPECT.Results:The scores of cognitive tests in diabetes group were significantly lower than those in control group.NIDDM patients were more deperssive and anxious than controls.The results of SPECT demonstrated the existence of regional hypo perfusiion of brain blood in NIDDM patients.The cognitive impairments were closely related to decreased blood perfusion in frontal and temporal lobes.Conclusion:Type Ⅱ diabetes patients have some cognitive dysfunction such as decreased memory,impaired attention,inflexible thought and decreased generalization capacity,which are related to physical and psychological factors.The hypo prefusion of cerebral blood flow and thereby inhibition of brain function may be responsible directly for impairment of cognitive function.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2000年第1期21-24,共4页
Chinese Mental Health Journal
关键词
Ⅱ型
糖尿病
认知功能
SPECT
心理测查
type Ⅱ diabetes mellitus\ \ cognitive function\ \ single photon emission computed tomography(SPECT)
