Correlation between hypoglycaemia and cognitive dysfunction in elderly diabetic patients
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摘要:
目的 探讨老年糖尿病低血糖患者的认知功能障碍情况,并分析低血糖与认知功能障碍的相关性。 方法 选取2019年6月—2020年6月于空军军医大学第一附属医院就诊的610例老年糖尿病患者为研究对象,依据患者是否发生过低血糖分为重度低血糖组24例,轻度低血糖组277例,非低血糖组309例; 依据患者低血糖的发生次数将患者分为低频次组(≤3次)351例,中频次组(3~7次)172例,高频次组(≥8次)87例。采用多元逐步回归分析低血糖与认知功能的相关性。 结果 (1) 非低血糖组患者认知功能得分[(26.13±1.28)分]明显优于轻度低血糖组[(24.92±1.12)分]和重度低血糖组[(24.73±1.25)分,F=78.601,P<0.01]。(2)不同低血糖发生次数组的认知功能障碍发生率的差异有统计学意义(P<0.05),高频次组认知功能障碍的发生率最高(68.97%),低频次组最低(38.75%); 不同低血糖发生程度组的认知功能障碍发生率的差异有统计学意义(P<0.05),重度低血糖组认知功能障碍的发生率最高(75.00%),无低血糖组发生率最低(31.07%)。(3)是否发生低血糖、低血糖的发生次数及程度是影响患者认知功能障碍的重要因素。 结论 低血糖是糖尿病患者认知障碍的危险因素,低血糖发生的次数及程度均可影响到老年糖尿病患者的认知水平。 Abstract:Objective To explore the cognitive dysfunction in elderly diabetic patients with hypoglycaemia and to analyse the correlation between hypoglycaemia and cognitive dysfunction. Methods A total of 610 elderly diabetic patients admitted at our hospital from June 2019 to June 2020 were selected as the research subjects. The patients were divided into the severe hypoglycaemia group (n=24), mild hypoglycaemia group (n=277) and non-hypoglycaemia group (n=309). According to the frequency of hypoglycaemia, the patients were divided into the low-frequency group (≤3 times, 351 cases), medium-frequency group (3-7 times, 172 cases) and high-frequency group (≥8 times, 87 cases). Multiple stepwise regression was used to analyse the correlation between hypoglycaemia and cognitive function. Results (1) The cognitive function score of the non-hypoglycaemia group [(26.13±1.28) points] was significantly better than that of the mild [(24.92±1.12) points] and severe hypoglycaemia groups [(24.73±1.25) points, F=78.601, P < 0.01]. (2) Statistically significant differences were observed in the incidence of cognitive dysfunction amongst groups with different frequency of hypoglycaemia (P < 0.05). The incidence of cognitive dysfunction was the highest in the high-frequency group (68.97%) and the lowest in the low-frequency group (38.75%). Significant differences were observed in the incidence of cognitive dysfunction amongst groups with different degrees of hypoglycaemia (P < 0.05). The incidence of cognitive dysfunction was the highest in the severe hypoglycaemia group (75.00%) and lowest in the non-hypoglycaemia group (31.07%). (3) The occurrence, frequency and degree of hypoglycaemia were important factors affecting patients' cognitive dysfunction. Conclusion Hypoglycaemia is a risk factor for cognitive impairment in diabetic patients. The frequency and degree of hypoglycaemia can affect the cognitive level of elderly diabetic patients. -
Key words:
- Diabetes /
- Hypoglycaemia /
- Elderly /
- Cognitive dysfunction
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表 1 不同血糖组老年糖尿病患者一般资料比较
组别 例数 性别(例) 年龄(x ±s,岁) 病程(x ±s,年) BMI (x ±s) 男性 女性 重度低血糖组 24 14 10 66.11±2.01 12.31±1.73 24.76±3.18 轻度低血糖组 277 145 132 66.38±2.16 12.45±1.75 24.79±3.16 非低血糖组 309 155 154 66.29±2.45 12.41±1.06 24.51±3.44 统计量 0.035a 0.017b 0.135b 0.539b P值 0.872 0.993 0.874 0.584 注:a为χ2值,b为F值。 表 2 影响老年糖尿病患者认知功能障碍的变量赋值
变量 赋值说明 性别 男=0,女=1 年龄 连续型计量资料 病程 连续型计量资料 BMI 连续型计量资料 是否患有糖尿病并发症 否=0,是=1 低血糖发生次数 ≤3次=0,3~7次=1,≥8次=2 低血糖发生程度 无低血糖=0,轻度低血糖=1,重度低血糖=2 认识功能障碍 无=0,有=1 表 3 影响老年糖尿病患者认知功能障碍的回归分析
项目 B SE Wald χ2 P值 OR(95% CI) 性别 -0.006 0.106 0.003 0.518 0.994(0.564~1.247) 年龄 -0.034 0.127 0.072 0.366 0.967(0.065~1.976) 病程 -0.086 0.264 0.106 0.193 0.918(0.489~1.527) BMI -0.068 0.251 0.073 0.217 0.934(0.875~2.389) 低血糖 0.278 0.564 0.243 0.019 1.321(1.235~2.828) 低血糖发生次数 1.084 0.626 2.999 0.012 2.956(1.639~3.636) 低血糖发生程度 1.383 0.484 8.165 0.036 3.985(2.164~4.849) 糖尿病并发症 0.018 0.326 0.003 0.176 1.018(0.683~1.785) -
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