【作者】 孙增荣；

【导师】 王建华； 孙丽荣；

【作者基本信息】 天津医科大学 ， 内科学， 2006， 博士

【摘要】 目的:探讨与2型糖尿病相关的认知功能障碍。 方法:采用以医院为基础的频数匹配病例对照研究方法。病例来自2005年3月至10月于天津医科大学代谢病医院就诊的2型糖尿病(T2DM)患者共118例。对照组:为同期于天津医科大学总医院接受健康检查的非糖尿病者共100例,对照组与病例组按年龄、性别、文化程度进行频数匹配。认知功能测试分别采用(1)简易智能状态评价(MMSE);(2)韦克斯勒成人智力量表中国修订版(WATS-RC)中的4项测验,即填图测验、数字广度、数字符号及类同测验;(3)临床记忆量表(甲套)全部5项测验。综合医院焦虑和抑郁量表(HAD)评价研究对象的焦虑和抑郁状态。采用t检验比较病例组与对照组认知功能评分差异,x2检验比较各调查因素在两组间分布的差异。 结果:病例组与对照组MMSE得分分别为27.0±3.2和27.8±2.0,差别未达到统计学显著性水平(t=1.668,P=0.098);病例组在填图测验、数字广度测验、数字符号及类同测验项目的年龄量表分均低于年龄、性别、文化程度匹配的对照组,差别均具有统计学意义(P均<0.001),说明病例组在逻辑思维能力、抽象思维能力、分析概括能力,视觉敏锐性、注意力、记忆力、信息处理速度及神经肌肉运动能力等方面的认知功能表现均差于对照组;病例组与对照组的记忆商(MQ)分别为90.0±15.6和100.3±12.8,两组MQ差别具有统计学意义(t=5.354,P<0.001)。病例组的MQ显著低于常模均数100(t=6.926,P<0.001),而对照组MQ与常模均数比较,无统计学差异(t=0.251,P=0.803),说明病例组存在记忆力损害。病例组在指向记忆、联想记忆、图像自由回忆、无意义图形再认、人像特点回忆五项分测验的年龄量表分均显著低于年龄、性别、文化程度匹配的对照组(P均<0.005),说明病例组的言语记忆(学习记忆)和非言语记忆(视空记忆)能力均存在不同程度的损害。本研究发现,不同年龄组(55岁以下组、55岁及以上组),不同性别的T2DM患者的多项认更多还原

【Abstract】 Objective: To explore the relationship of type 2 diabetes to cognitive impairment. Methods: A hospital-based frequency matched case-control study was conducted. 118 type 2 diabetes mellitus (T2DM) patients were compared with 100 age, gender and level of education matched non-diabetic controls. Cognitive function of the subjects was assessed by the following cognitive tests: (1) Mini-Mental State Examination (MMSE);(2) Four cognitive tests from Wechsler Adult Intelligence Scale-Revised in China (WATS-RC), namely, Picture Completion Test, Digit Span Test, Digit Symbol Substitution Test and the Similarities Test;(3) Clinical Memory Scale (CMS). The anxiety and depression symptoms of the subjects were assessed using Hospital Anxiety and Depression Scale (HAD). The statistical differences of cognitive scores between case and control groups were examined with t-test. Chi-square test was used to examine the differences for variable’s proportions.Results: The MMSE scores of case and control groups were 27.0±3.2 and 27.8±2.0 respectively, which had no statistical difference between two groups (t=1.668, P=0.098) . The scores of four WATS-RC tests were all significantly lower in the cases than those in the controls. The results indicate that the cases were likely to be cognitively impaired in several cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed. The mean memory quotient (MQ) of the case group was significantly lower than that of the control group(90.0±15.6 vsl00.3±12.8, t=5.354, P<0.001). Similarly, the mean MQ of the case group was also significantly lower than the mean of Norm, while no significant difference of MQ was found between control group and the Norm (t=0.251, P=0.803) . The scores of 5 memory tests fromCMS in the cases were all significantly lower than those in the controls, which suggested that the case group had impaired verbal memory and visuospatial memory. Both age groups ( below 5 5-years old group and 5 5-years or older group) and gender groups of the cases had poorer performance in a number of cognitive tests copmpared with the controls, which indicate that the cases in different age and gender groups have impaired cognitive function. The results of HAD showed that the scores of depression in the case group were higher than those in the control group.Conclusion: Results from the present study suggest that type 2 diabetes are associated with cognitive impairment in a number of cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed, verbal memory and visuospatial memory. Further studies on delineating the mechanisms of the observed associations are warranted.更多还原