2022 年第 4 期 第 17 卷

糖调节受损与缺血性脑小血管病患者认知障碍的相关性 

Relationship between impaired glucose regulation and cognitive impairment in patients with ischemic cerebral small vessel disease

作者：姚琳王雅楠刘斌孟琳

英文作者：Yao Lin Wang Yanan Liu Bin Meng Lin

单位：华北理工大学附属医院神经内一科，唐山063000

英文单位：First Department of Neurology North China University of Science and Technology Affiliated Hospital Tangshan 063000 China

关键词：缺血性脑小血管病；糖调节受损；认知障碍

英文关键词：Ischemiccerebralsmallvesseldisease;Impairedglucoseregulation;Cognitiveimpairment

• 摘要：

• 目的 探讨糖调节受损（IGR）与缺血性脑小血管病（CSVD）患者认知障碍的相关性。方法 回顾性分析华北理工大学附属医院2019年9月至2021年3月收治的455例非糖尿病缺血性CSVD患者的临床资料，根据患者认知功能评估情况分为认知正常组(238例）和认知障碍组（217例）。比较2组性别、年龄、体重指数，吸烟、饮酒、高血压病和冠心病(冠状动脉粥样硬化性心脏病)比例，血脂和血尿酸水平，伴IGR情况，分析缺血性CSVD患者发生认知障碍的危险因素，以及IGR与认知障碍的相关性。结果 认知障碍组年龄大于认知正常组［(69±4)岁比（68±4）岁］，高密度脂蛋白胆固醇水平低于认知正常组［(1.25±0.28)mmol/L比（1.34±0.31）mmol/L］，血尿酸水平和合并IGR比例均高于认知正常组［(353±114)mmol/L比（300±98）mmol/L、54.8%(119/217)比26.5%（63/238）］（均P＜0.01）。多因素Logistic回归分析结果显示，年龄、血尿酸和IGR均为缺血性CSVD患者发生认知障碍的危险因素（均P＜0.01）。Spearman相关分析结果显示，IGR与缺血性CSVD患者认知障碍严重程度呈正相关（r=0.597，P<0.01）。结论 IGR与缺血性CSVD患者认知障碍严重程度呈正相关，IGR可能参与了缺血性CSVD患者认知障碍的发生、发展过程。

• Objective To investigate the relationship between impaired glucose tolerance (IGR) and cognitive impairment in patients with ischemic cerebral small vessel disease (CSVD). Methods From September 2019 to March 2021, clinical data of 455 patients with non diabetic ischemic CSVD admitted to North China University of Science and Technology Affiliated Hospital were retrospectively analyzed. According to cognitive function assessment, patients were divided into cognitive normal group (238 cases) and cognitive impairment group (217 cases). Gender, age, body mass index, proportions of smoking, drinking, hypertension and coronary atherosclerotic heart disease, levels of blood lipid and serum uric acid, and IGR situation were compared between the two groups. The risk factors of cognitive impairment in patients with ischemic CSVD and the relationship between IGR and cognitive impairment were analyzed. Results The age of cognitive impairment group was elder than cognitive normal group ［(69±4)years vs (68±4)years］, the level of high-density lipoprotein cholesterol decreased ［(1.25±0.28)mmol/L vs (1.34±0.31)mmol/L］, and the level of serum uric acid and the proportion of IGR increased ［(353±114)mmol/L vs (300±98)mmol/L, 54.8%(119/217) vs 26.5%(63/238)］(all P<0.01). Multivariate Logistic regression analysis showed that age, serum uric acid and IGR were the risk factors of cognitive impairment in patients with ischemic CSVD (all P<0.01). Spearman correlation analysis showed that IGR was positively correlated with the severity of cognitive impairment in patients with ischemic CSVD (r=0.597, P<0.01). Conclusions IGR is positively correlated with the degree of cognitive impairment in patients with ischemic CSVD. IGR may be involved in the occurrence and development of cognitive impairment in patients with ischemic CSVD.