糖尿病与非糖尿病急性脑梗死患者非痴呆性血管性认知障碍的相关因素差异分析

Differential analysis of factors related to vascular cognitive impairment no dementia in diabetic and non-diabetic patients with acute cerebral infarction

关键词:  2型糖尿病  急性脑梗死  非痴呆性血管性认知障碍  MoCA量表

Key words:  T2DM  acute cerebral infarction  vascular cognitive impairment not dementia  MoCA scale

摘要:

目的 研究2型糖尿病（diabetes mellitus type 2，T2DM）与非T2DM的急性脑梗死患者非痴呆性血管性认知障碍（vascular cognitive impairment no dementia，VCIND）的相关因素差异。方法 连续选择发病2周以内的，首次诊断为急性脑梗死患者，将其中符合VCIND诊断对象入组，登记入组患者一般情况、生物学因素及检查结果，再将所有入组患者分为T2DM组与非T2DM组，对两组患者一般情况、生物学因素及检查结果、MoCA量表等情况进行比较分析。结果 T2DM组与非T2DM组比较，T2DM组颈动脉粥样硬化患者比例高，两组间比较差异有统计学意义（P=0.002，P<0.01）；T2DM组MoCA量表总得分低，两组间比较差异有统计学意义（P=0.047，P<0.05）；各分项得分中，T2DM组执行功能得分更低（P=0.025，P<0.05），记忆功能得分更低（P=0.001，P<0.01）；其他各分项得分均无统计学差异。结论 T2DM与非T2DM急性脑梗死患者VCIND比较发现，T2DM组颈动脉粥样硬化患者比例高，认知功能损伤更重。

Abstract:

Objective To investigate the different factors related to vascular cognitive impairment no dementia (VCIND) in T2DM and non-T2DM patients complicated with acute cerebral infarction. Methods Patients, who was diagnosed with acute cerebral infarction for the first time (within 2 weeks of onset) and met the classification and diagnostic criteria of Guidelines for Diagnosis and Treatment of Vascular Cognitive Impairment formulated by dementia and cognitive impairment group of neurology branch of the Chinese Medical Association (2011 edition), were enrolled in the study. Clinical data on the general condition, biological factors and lab results were reviewed. The patients were divided into two groups, T2DM group and non-T2DM group. The differences of the general conditions, biological factors, total score of MoCA scale, and various parts of MoCA between the two groups were compared. Results In comparison between T2DM and non-T2DM groups, the proportion of patients with carotid atherosclerosis in T2DM group was higher (P=0.002), the total MoCA score was lower in T2DM group (P=0.047). Compared with non-T2DM group, the scores of executive test and memory test in T2DM group were lower (P=0.025 and P=0.001, respectively). There were not statistically significant differences in other scores. Conclusion Comparision of VCIND in T2DM and non-T2DM patients with acute cerebral infarction demonstrates that the proportion of patients with carotid atherosclerosis in T2DM group is higher, and the cognitive impairment is more serious.