Objective To study the relationship between 24-hour ambulatory blood pressure circadian rhythm and cognition function in the patients of elderly type 2 diabetes.Methods Two hundred and seventy elderly patients of type 2.diabetes were performed 24-hour ambulatory blood pressure monitoring (ABPM), and divided into dipper group (n=95), non-dipper group (n=86), super-dipper group (n=47) and reverse-dipper group (n=42).100 healthy subjects served as control.Cognition function were evaluated by Mini-Mental State Examination(MMSE).Results MMSE of type 2 diabetes group was significantly lower than that of control (24.34±2.51 vs.control: 28.88±3.02, P＜0.05).MMSE of non-dipper group, super-dipper group and reverse-dipper group were significantly lower than that of dipper group, super-dipper group and reverse-dipper group were also lower than that of non-dipper group (non-dipper.24.77±2.53 vs.super-dipper: 23.34±2.41 vs.reverse- dipper:23.03±2.26 vs.dipper: 26.03±2.68 ,respectively P＜0.05),but there was no significant difference between super-dipper and reverse-dipper group.Pearson correlation analysis showed that,MMSE was negatively correlated with 24hSBP(r=-0.73),24hDBP(r=-0.60),24hPP(r=-0.54)and 24hMBP(r=-0.56)(all P＜0.05).Conclusions The decrease on cognition function in the patients of elderly type 2 diabetes may be related with the attenuation or disappearance of 24-hour ambulatory blood pressure circadian rhythm.%目的 探讨老年2型糖尿病(T2DM)患者认知功能与24h动态血压昼夜节律变化特点.方法 选择270例老年T2DM患者为糖尿病组,另选择同期健康体检者100例为对照组.对两组行24 h动态血压监测,根据夜间血压下降率(△MBP)分为杓型(△MBP 10%～20%,n=95)、非杓型(△MBP 0%～＜10%,n=86)、超杓型(△MBP＞20%,n=47)和反杓型(△MBP＜0%,n=42);用中文版简易智能状态检查表(MMSE)对所有受试者进行认知功能调查,比较各组间MMSE得分的差异.结果 糖尿病组患者MMSE得分[(24.34±2.51)分]低于对照组[(28.88±3.02)分],差异有统计学意义(P＜0.05).糖尿病组中非杓型[(24.77±2.53)分]、超杓型[(23.34±2.41)分]和反杓型[(23.03±2.26)分]患者的MMSE得分均低于杓型[(26.03±2.68)分]患者,超杓型和反杓型又低于非杓型患者,差异有统计学意义(P＜0.05),但超杓型和反杓型之间的差异无统计学意义.Pearson相关分析显示,糖尿病患者MMSE得分与24hSBP(r=-0.73)、24hDBP(r=-0.60)、24hPP(r=-0.54)、24hMBP(r=-0.56)呈负相关(P＜0.05).结论 24 h动态血压昼夜节律的减弱或消失可能是老年T2DM患者认知功能受损的相关因素.
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