摘要
目的探讨老年2型糖尿病(T2DM)病人伴发认知功能障碍的危险因素,为早期防治提供理论依据。方法收集2014年6月至2016年2月我院符合研究标准的年龄≥65岁的老年T2DM病人100例,全面采集病人的病史、受教育程度、吸烟史、伴随疾病、体格检查,并进行血糖、同型半胱氨酸、肝肾功能及甲状腺功能等实验室检查,心电图和颅脑MR或CT,简易智能精神状态检查量表(MMSE)评估等。根据是否伴有认知功能障碍将病人分为2组,即T2DM伴有认知功能障碍组(A组)及T2DM不伴认知功能障碍组(B组),应用单因素分析及Logistic逐步回归方法进行影响因素分析。结果 100例老年T2DM病人中,发现伴有认知功能障碍病人48例,占48%;单因素分析提示伴有认知功能障碍病人与无认知功能障碍病人相比,受教育程度、血糖控制情况、伴高同型半胱氨酸方面差异有统计学意义(P<0.05);而2组家族史、遗传史、吸烟、肥胖等差异无统计学意义(P>0.05);Logistic逐步回归分析结果显示,血糖控制差、高水平同型半胱氨酸与T2DM病人是否伴有认知障碍呈正相关,受教育程度与认知障碍呈负相关。结论认知功能障碍在老年T2DM病人中发病率较高,血糖控制差、高同型半胱氨酸血症、受教育程度低可能是老年T2DM病人发生认知障碍的危险因素。
Objective To analyze the risk factors of cognitive impairment,and provide evidence for early prevention and treatment in elderly patients with type 2 diabetes. Methods A total of 100 patients with type 2 diabetes aged 65 and over were enrolled in the study from June 2014 to February2016 in our hospital. A thorough medical history,level of education,smoking history,combined disease,physical examination were collected,and blood glucose,homocysteine,hepatic and renal function,thyroid function were detected, and the electrocardiogram, cranial MR or CT,mini-mental state examination（ MMSE） were performed in all patients. And they were divided into two groups according to the cognitive examination. Univariate analysis and Logistic stepwise regression were used to identify influencing factors. Results Among 100 patients,48 cases were diagnosed as cognitive impairment,with an incidence rate of 48%. Univariate analysis showed significant difference in education level,poor blood glucose control,hyperhomocysteinemia（ HHcy）（ P〈0. 05）,while no significant difference in smoking history,family history and inheritance history obesity（ P〉0. 05） between two groups. Logistic stepwise regression showed positive correlation between poor blood glucose control and HHcy,and education showed negative correlation in the type 2 diabetes patients with cognitive impairment.Conclusions Cognitive impairment is highly prevalent in elderly patients with type 2 diabetes. Poor blood glucose control,HHcy and low education may be the risk factors of elderly type 2 diabetes with cognitive impairment.
作者
孟洁
孟云霞
MENG jie MENG Yun-xia.(Department of Geriatrics, the First People＇s Hospital of Lianyungang, Lianyungang 222000, Chin)
出处
《实用老年医学》
CAS
2017年第3期277-279,共3页
Practical Geriatrics
