血糖控制不佳2型糖尿病患者轻度认知障碍影响因素研究

摘要

Objective To explore the influencing factors of mild cognitive impairment(MCI)in type 2 diabetes patients with poor glycemic control in order to provide the reference for the control and prevention.Methods A total of 181 patients[105 males and 76 females,at an age of(59.0 ±8.5)years,ranging from 45 to 75]with type 2 diabetes mellitus(T2DM)admitted in the Department of Endocrinology from 2 hospitals from October 2014 to May 2015 were enrolled in this study.Montreal Cognitive Assessment(MoCA) was used to assess the subjects for cognitive impairment,and the influencing factors were analyzed.SPSS statistics 16.0 was used to analyze the data.Student's t test or Chi-square test were used to compare the differences between groups.Univariate analysis was adopted to obtain the factors affecting the cognitive function of T 2DM patients, and then logistic regression analysis was employed to analyze the risk factors for MCI.Results About 52.5% of T2DM patients with poor glycemic control experienced mild cognitive impairment.The univariate analysis showed that age, gender, educational level, monthly income of a family, drinking, smoking, history of cerebral infarction,diabetic peripheral neuropathy, history of hypoglycemia and ratio of albumin to creatinine(A/C)were related with MCI(P <0.05).The multivariate logistic regression analysis indicated that age was positively correlated with MCI (OR=1.437,95%CI 1.017-2.029,P<0.05),while educational level and history of hypoglycemia were negatively correlated with MCI(OR=0.326,95%CI 0.197-0.539, P<0.05; OR=0.400,95%CI 0.167-0.958, P<0.05).Conclusion Physicians should pay attention to the cognitive function in the T 2DM patients with poor glycemic control,and take various measures to slow the cognitive decline.%目的 探讨血糖控制不佳2型糖尿病患者(T2DM)轻度认知障碍(MCI)发生的影响因素,为疾病预防与控制提供依据.方法 入选2014年10月至2015年5月安徽医科大学第一附属医院和第二附属医院内分泌科T2DM患者181例,其中男性105例,女性76例,年龄45~75(59.0±8.5)岁,采用长沙版蒙特利尔认知评估量表(MoCA)评定患者的总体认知,了解认知损害现状并根据得分分组分析影响因素.应用SPSS 16.0统计软件对数据进行分析.采用t检验或χ2检验比较组间差异.单因素分析影响T2DM患者认知功能的因素,进一步采用logistic回归分析发生MCI的危险因素.结果 血糖控制不佳T2DM患者的MCI患病率为52.5%(95/181).单因素分析显示年龄、性别、文化程度、家庭人均月收入、饮酒、吸烟、脑梗死史、糖尿病周围神经病变、低血糖史和尿微量白蛋白/肌酐比值(A/C)比值与MCI相关(P<0.05).多因素logistic回归显示年龄与MCI正相关(OR=1.437,95%CI 1.017~2.029;P<0.05),教育程度和低血糖史与MCI负相关(OR=0.326,95%CI 0.197~0.539;OR=0.400,95%CI 0.167~0.958;P<0.05).结论 医务人员应关注血糖控制不佳T2DM患者的认知功能,及时采取措施延缓认知功能减退.