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目的探讨2型糖尿病患者认知功能障碍与血清总同型半胱氨酸(tHcy)水平之间的关系,并分析影响认知功能的其他因素。方法根据简易精神状态量表(MMSE)评分将2型糖尿病患者分为糖尿病认知障碍组(30例)、糖尿病非认知障碍组(32例)和正常对照组(30例)。用特定蛋白分析仪免疫散射比浊法测定血清tHcy,并测定糖化血红蛋白、血脂、尿酸、纤维蛋白原、24h尿微量白蛋白等指标。结果糖尿病认知障碍组血清tHcy水平高于糖尿病非认知障碍组(P<0.05)及正常对照组(P<0.01);2型糖尿病患者MMSE评分与年龄、糖尿病病程、糖化血红蛋白、体质指数及血清tHcy水平呈负相关(r值分别为-0.315、-0.384、-0.276、-0.282、-0.309,P<0.05)。结论血清tHcy升高是2型糖尿病患者认知功能下降的一个重要危险因素,可能参与了糖尿病脑病的发病。
Objective To investigate the relationship between cognitive dysfunction and serum total homocysteine (tHcy) in type 2 diabetes mellitus (T2DM) and to analyze other factors affecting cognitive function. Methods Patients with type 2 diabetes were divided into diabetic cognitive impairment group (30 cases), diabetes non-cognitive impairment group (32 cases) and normal control group (30 cases) according to MMSE score. Serum tHcy levels were determined by immunostaining turbidimetry using a specific protein analyzer. The indexes of glycosylated hemoglobin, lipids, uric acid, fibrinogen and 24h urine microalbumin were determined. Results The level of serum tHcy in diabetic cognitive impairment group was higher than that in non-cognitive diabetes group (P <0.05) and normal control group (P <0.01). MMSE score and age, diabetes course, glycosylated hemoglobin, body mass index Serum tHcy levels were negatively correlated (r values were -0.315, -0.384, -0.276, -0.282, -0.309, P <0.05). Conclusion The increase of serum tHcy is an important risk factor of cognitive decline in type 2 diabetes mellitus, which may be involved in the pathogenesis of diabetic encephalopathy.