阿尔茨海默病与2型糖尿病关系的调查分析

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摘要目的研究阿尔茨海默病（AD）与2型糖尿病（T2DM）的关系。方法选取2017—2020年辽宁省金秋医院神经内科首次住院的高龄AD患者150例，按是否合并T2DM及病程分为非T2DM组84例、T2DM≤5年组29例、T2DM＞5年组37例，观察各组的基本资料和认知功能评分。将AD合并T2DM患者按是否控制血糖治疗分为A组43例和B组23例，观察两组AD病程及认知功能评分。分析T2DM病程及空腹血糖（FBG）水平对AD病程及认知功能的影响。结果非T2DM组、T2DM≤5年组及T2DM＞5年组体重指数、脑卒中发生率、FBG及AD病程比较，差异有统计学意义（P ＜ 0.05）。非T2DM组、T2DM≤5年组及T2DM＞5年组简易精神状态量表（MMSE）、日常生活能力量表（ADL）及AD病理行为评分量表（BEHAVE-AD）评分比较，差异有统计学意义（P ＜ 0.05）。与A组比较，B组AD病程延长，FBG水平、糖化血红蛋白升高，MMSE评分降低，AD评定量表-认知评分、BEHAVE-AD评分及ADL评分升高，差异有统计学意义（P ＜ 0.05）。T2DM病程及FBG水平是AD病程、MMSE评分、BEHAVE-AD及ADL评分的影响因素（P ＜ 0.05）。结论 AD合并T2DM患者AD病程长，认知功能下降明显，长病程T2DM及高血糖水平能促进AD的进展。因此，AD患者如果早期发现T2DM，应及时控制血糖治疗，可能延缓AD的进展。

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	张淑艳孙蜀宁

关键词 ：阿尔茨海默病, 2型糖尿病, 认知功能, 血糖, 病程

Abstract：Objective To study the correlation between Alzheimer’s disease (AD) and type two diabetes mellitus (T2DM). Methods One hundred and fifty senile patients with AD first hospitalized in Department of Internal Neurology of Jinqiu Hospital of Liaoning Province from 2017 to 2020 were selected. According to whether combined with T2DM and the course of disease, they were divided into 84 cases in non-T2DM group, 29 cases in T2DM less than or equal to five years group and 37 cases in T2DM more than five years group. The basic data and cognitive function scores of each group were observed. The patients with AD complicated with T2DM were divided into 43 cases in group A and 23 cases in group B according to whether to control blood glucose or not, the course of AD and the score of cognitive function were observed. The effects of the course of T2DM and the level of fasting blood glucose (FBG) on the course of AD and cognitive function were analyzed. Results Body mass index, incidence of stroke, FBG and course of AD in non-T2DM group, T2DM less than or equal to five years group, and T2DM more than five years group were compared, and the differences were statistically significant (P ＜ 0.05). Mini-mental state scale (MMSE), activity of daily living scale (ADL) and AD pathological behavior scale (BEHAVE-AD) scores in non-T2DM group, T2DM less than or equal to five years group, and T2DM more than five years group were compared, the differences were statistically significant (P ＜ 0.05). Compared with group A, the course of AD in group B was prolonged, FBG levels and glycosylated hemoglobin increased, MMSE score decreased, Alzheimer’s disease assessment scale-congnitive score, BEHAVE-AD score, and ADL score increased, and the differences were statistically significant (P ＜ 0.05). The course of T2DM and FBG level were influencing factors of the course of AD, MMSE score, BEHAVE-AD, and ADL score (P ＜ 0.05). Conclusion Patients with AD complicated with T2DM have a long course of AD and a significant decline in cognitive function. Long course T2DM and hyperglycemia can promote the progress of AD. Therefore, if T2DM is found early in AD patients, blood glucose should be controlled in time, which may delay the progress of AD.

Key words： Alzheimer’s disease Type two diabetes mellitus Cognitive function Blood glucose Course of disease

基金资助:辽宁省省直医院改革重点临床科室诊疗能力建设项目（LNCCC-D39-2015）。

通讯作者: 孙蜀宁（1967.10-），女，主任医师，主要从事脑血管病、痴呆及神经系统变性病等疾病的研究。

作者简介: 张淑艳（1982.12-），女，硕士，副主任医师，主要从事脑血管病及痴呆等疾病的研究。

引用本文:

张淑艳孙蜀宁. 阿尔茨海默病与2型糖尿病关系的调查分析[J]. 中国医药导报, 2022, 19(20): 53-57.
ZHANG Shuyan SUN Shuning. Research analysis of the correlation between Alzheimer’s disease and type two diabetes mellitus. 中国医药导报, 2022, 19(20): 53-57.

链接本文:

https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I20/53

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