中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
8期
813-816
,共4页
萧丽军%缪珩%祝群%钱云%王春雪
蕭麗軍%繆珩%祝群%錢雲%王春雪
소려군%무형%축군%전운%왕춘설
糖尿病,2型%认知障碍%因素分析,统计学
糖尿病,2型%認知障礙%因素分析,統計學
당뇨병,2형%인지장애%인소분석,통계학
Diabetes,type 2%Cognition disorders%Factor analysis,statistical
目的 分析影响老年2型糖尿病轻度认知损害(MCI)患者认知减退的多种因素及其可能存在的交互作用,以期更加全面评估患者预后,指导临床治疗.方法 采用巢式病例-对照研究方法,由612例患有轻度认知功能障碍的2型糖尿病患者组成随访队列,按照年龄、性别、文化程度1∶1匹配后形成认知减退组和对照组,采用单因素分析结合多因素分析的方法确定患者认知减退的影响因素.采用相加效应模型分析影响因素间的交互作用.结果 非在婚包括未婚、离异、丧偶、分居等(OR=2.237,95％CI:1.022～4.896)、喜欢待在家里(OR=2.267,95％CI:1.177～4.366)、不常读书看报(OR=2.819,95％CI:1.276～7.839)、合并高血压(OR=3.298,95％CI:1.417～7.675)、吸烟(OR=2.927,95％CI:1.237～6.925)、饮酒(OR=2.439,95％CI:1.116～7.211)、糖尿病微血管病变(OR=2.895,95％CI:1.227～6.830)、糖尿病病程长(OR=3.672,95％CI:1.552～8.687)、血糖控制水平差(OR=3.418,95％CI:1.226～9.529),均是患者发生认知功能减退的危险因素；糖尿病微血管病变与吸烟、饮酒之间的交互作用,其归因效应百分比分别为68.9％、32.9％,超相对危险比分别为10.621、7.238.结论 吸烟、饮酒与糖尿病微血管病变对患者认知减退存在正交互作用.
目的 分析影響老年2型糖尿病輕度認知損害(MCI)患者認知減退的多種因素及其可能存在的交互作用,以期更加全麵評估患者預後,指導臨床治療.方法 採用巢式病例-對照研究方法,由612例患有輕度認知功能障礙的2型糖尿病患者組成隨訪隊列,按照年齡、性彆、文化程度1∶1匹配後形成認知減退組和對照組,採用單因素分析結閤多因素分析的方法確定患者認知減退的影響因素.採用相加效應模型分析影響因素間的交互作用.結果 非在婚包括未婚、離異、喪偶、分居等(OR=2.237,95％CI:1.022～4.896)、喜歡待在傢裏(OR=2.267,95％CI:1.177～4.366)、不常讀書看報(OR=2.819,95％CI:1.276～7.839)、閤併高血壓(OR=3.298,95％CI:1.417～7.675)、吸煙(OR=2.927,95％CI:1.237～6.925)、飲酒(OR=2.439,95％CI:1.116～7.211)、糖尿病微血管病變(OR=2.895,95％CI:1.227～6.830)、糖尿病病程長(OR=3.672,95％CI:1.552～8.687)、血糖控製水平差(OR=3.418,95％CI:1.226～9.529),均是患者髮生認知功能減退的危險因素；糖尿病微血管病變與吸煙、飲酒之間的交互作用,其歸因效應百分比分彆為68.9％、32.9％,超相對危險比分彆為10.621、7.238.結論 吸煙、飲酒與糖尿病微血管病變對患者認知減退存在正交互作用.
목적 분석영향노년2형당뇨병경도인지손해(MCI)환자인지감퇴적다충인소급기가능존재적교호작용,이기경가전면평고환자예후,지도림상치료.방법 채용소식병례-대조연구방법,유612례환유경도인지공능장애적2형당뇨병환자조성수방대렬,안조년령、성별、문화정도1∶1필배후형성인지감퇴조화대조조,채용단인소분석결합다인소분석적방법학정환자인지감퇴적영향인소.채용상가효응모형분석영향인소간적교호작용.결과 비재혼포괄미혼、리이、상우、분거등(OR=2.237,95％CI:1.022～4.896)、희환대재가리(OR=2.267,95％CI:1.177～4.366)、불상독서간보(OR=2.819,95％CI:1.276～7.839)、합병고혈압(OR=3.298,95％CI:1.417～7.675)、흡연(OR=2.927,95％CI:1.237～6.925)、음주(OR=2.439,95％CI:1.116～7.211)、당뇨병미혈관병변(OR=2.895,95％CI:1.227～6.830)、당뇨병병정장(OR=3.672,95％CI:1.552～8.687)、혈당공제수평차(OR=3.418,95％CI:1.226～9.529),균시환자발생인지공능감퇴적위험인소；당뇨병미혈관병변여흡연、음주지간적교호작용,기귀인효응백분비분별위68.9％、32.9％,초상대위험비분별위10.621、7.238.결론 흡연、음주여당뇨병미혈관병변대환자인지감퇴존재정교호작용.
Objective To analyze the cognitive function impairment factors and their interactions in elderly type 2 diabetes mellitus patients with mild cognitive impairment,in order to fully evaluate the prognosis and guide the clinical treatment.Methods A total of 612 elderly type 2 diabetes patients with mild cognitive impairment were selected in this nested case-control study.Patients were divided into the cognitive decline group and the control group matched for age,sex,culture degree and paired for observation.Risk factors for cognitive function decline were determined by single factor analysis and multivariate analysis methods.The interactions between factors were analyzed by additive effects model.Results The risk factors for cognitive function decline were non married,preferring to stay at home,less reading,hypertension,smoking,alcohol,diabetic microangiopathy,long diabetes duration,hyperglycemia (OR=2.237,2.267,2.819,3.298,2.927,2.439,2.895,3.672,3.418,95％CI:1.022-4.896,1.177-4.366,1.2767.839,1.417-7.675,1.237-6.925,1.116-7.211,1.227-6.830,1.552-8.687,1.226-7.894,respectively).Diabetic microangiopathy had a interaction with smoking and drinking,their percentages of AP (AB) were 68.9％,32.9％ and relative risk ratios of RERI were 10.621,7.238 respectively.Conclusions Diabetic microangiopathy has a positive interaction with smoking,and drinking in elderly type 2 diabetes mellitus with mild cognitive impairment.
