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目的探讨2型糖尿病患者轻度认知功能障碍(MCI)的危险因素。方法选用蒙特利尔认知评估(MoCA)北京版量表作为认知功能的测评工具,选择2型糖尿病合并MCI组患者93例(MCI组)和2型糖尿病无MCI患者64例(NC组)。收集两组患者的个人史、家族史,检测体质指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、C肽、血脂、血压及颈动脉彩超。结果 MCI组患者高血压病史、糖尿病病程及C肽水平、最大颈动脉内膜中层厚度(IMT)、最小颈动脉阻力指数(RI)与NC组比较,差异均有统计学意义(P<0.05);而两组患者高脂血症病史及其病程、糖尿病家族史、高血压病程、性别构成、年龄、BMI、WHR、血压、血糖(FPG、HbA1c)及血脂水平间差异无统计学意义(P>0.05)。患者的C肽水平与MoCA量表评分呈正相关(P<0.01),高血压病史、糖尿病病程、最大IMT、最小RI与MoC量表评分呈负相关(P<0.05)。多元回归分析显示,高血压病史、C肽水平及最小RI是MoCA量表评分的独立危险因素(P<0.01)。结论 2型糖尿病病程、高血压病史、C肽、颈动脉IMT及颈动脉RI可能是患者发生MCI的危险因素。
Objective To investigate the risk factors of mild cognitive impairment (MCI) in type 2 diabetic patients. Methods The Montreal Scale of Cognitive Assessment (MoCA) Beijing Scale was used as a measure of cognitive function. Ninety-three MCI patients (MCI group) and 64 non-MCI patients (NC group) with type 2 diabetes mellitus were enrolled in this study. The personal history, family history, BMI, WHR, FPG, HbA1c, C-peptide, lipids, blood pressure and carotid ultrasonography were collected. Results There was significant difference in the history of hypertension, duration of diabetes and C peptide, maximum carotid intima-media thickness (IMT) and minimum carotid resistance index (RI) between MCI group and NC group (P <0.05) ; There was no significant difference between the two groups in the history of hyperlipidemia and its course of disease, family history of diabetes, course of hypertension, sex composition, age, BMI, WHR, blood pressure, blood glucose (FPG, HbA1c) > 0.05). The level of C-peptide in patients was positively correlated with MoCA scale (P <0.01). The history of hypertension, duration of diabetes mellitus, maximum IMT, minimum RI were negatively correlated with MoC scale (P <0.05). Multivariate regression analysis showed that the history of hypertension, C-peptide level and minimum RI were independent risk factors of MoCA scale (P <0.01). Conclusion The duration of type 2 diabetes mellitus, history of hypertension, C-peptide, carotid IMT and carotid artery RI may be the risk factors of MCI in patients.