糖尿病足患者合并认知功能障碍的相关危险因素分析

Risk factors of cognitive impairment in patients with type 2 diabetic foot

关键词:  糖尿病足  轻度认知功能障碍（MCI）  危险因素

Key words:  diabetic foot  mild cognitive impairment  risk factor

摘要:

目的　分析2型糖尿病足患者合并轻度认知功能障碍（mild cognitive impairment，MCI）的相关危险因素。方法　采用MoCA量表，比较2型糖尿病足患者与非糖尿病足患者（对照组）的认知功能及糖尿病足Wagner各分级间认知功能各项评分的差异。依据MoCA量表评分将糖尿病足患者分为MCI组和认知功能正常（normal cognitive，NC）组，对两组的自然情况、生物学因素及实验室检查情况进行比较，并分析MCI的相关危险因素。结果　2型糖尿病足患者与对照组MoCA总分值比较差异无统计学意义，但在注意力、延迟回忆亚测试中，2型糖尿病足组较对照组下降明显，差异有统计学意义（P<0.05）。F4、F5级糖尿病足患者注意力、延迟回忆评分及MOCA总分与F0级患者比较，差异均有统计学意义（P<0.05）。MCI组和NC组比较，年龄、BMI、有无糖尿病视网膜病变、FBG、PBG、HbA1c、TC、LDL-C方面差异均有统计学意义（P<0.05）。MoCA评分与患者年龄、糖尿病视网膜病变、糖尿病足严重程度、FBG、PBG、HbA1C、TC和LDL-C呈负相关；糖尿病视网膜病变、HbA1c和糖尿病足严重程度是2型糖尿病足患者合并MCI的独立危险因素。结论　2型糖尿病足患者认知功能障碍与多种因素相关，控制其危险因素有助于预防认知功能障碍。

Abstract:

Objective 　 To investigate the relative risk factors of mild cognitive impairment (MCI) in patients with type 2 diabetic foot.　Methods 　 MoCA scale was used to compare the cognitive function in patients with type 2 diabetic foot and the patients without diabetic foot (control group), and the scores of cognitive function among different grades of diabetic foot (Wagner). According to the MoCA, diabetic foot patients were divided into MCI group and normal cognitive function (NC) group. Two groups were compared through the natural conditions, biological factors and laboratory tests, and the related risk factors of MCI were also analyzed.　Results 　 There was no statistical significance in the total score of MoCA between the two groups. In diabetic foot patients group, the attention and delayed memory decreased significantly (P<0.05), compared to the control group. Compared with F0 level, the differences in F4 and F5 level about the attention, delayed recall score and MoCA total score were statistically significant (P<0.05). Comparisons of age, BMI, with/without diabetic retinopathy, FBG, PBG, HbA1c, TC and LDL-C between MCI group and NC group were statistically significant (P<0.05). The grade of MoCA score was negatively correlated with age, diabetes retinopathy, diabetes foot, FBG, PBG, HbA1c, TC and LDL-C. The diabetic retinopathy, HbA1c and diabetic foot severity are the independent risk factors for MCI. 　Conclusion 　 MCI in patients with type 2 diabetic foot is associated with various factors and it is helpful to control the risk factors preventing MCI.