代谢综合征患者42例认知功能损害特征研究
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摘要
目的研究代谢综合征患者认知功能损害特征及其脑电改变特点。方法选取2017年5月至2018年5月陆军军医大学第三附属医院住院的96例患者,其中2型糖尿病34例,高血压20例,代谢综合征42例,分别完成体检、实验室检查、认知功能量表评估、事件相关电位(ERP)P300脑电波检查。结果三组间空腹血糖、糖化血红蛋白(HBA_1c)、收缩压、体重指数、腰围、三酰甘油差异有统计学意义(P<0.05);代谢综合征组认知功能较糖尿病、高血压组下降,表现在数字广度记忆测试、视觉空间能力、记忆力与执行力-记忆、记忆力与执行力-总体方面评分明显减低(P<0.05);代谢综合征组Fz点(前额叶)P300波潜伏期较糖尿病、高血压组显著延长(P<0.05),同时波幅较糖尿病组缩短(P<0.05),但与高血压组比较差异无统计学意义(P>0.05)。结论代谢综合征患者认知功能损害表现在记忆、执行、视觉空间等,具有自身损害特点,且事件相关电位表现为前额叶对信息加工处理时间延长,处理能力减低。
Objective To explore the characteristics of cognitive impairment and the characteristics of EEG changes in patients with metabolic syndrome. Methods Totally 96 patients hospitalized between May 2017 and May 2018 were included in this study.Among them, there were 34 patients with type 2 diabetes, 20 patients with hypertension, and 42 patients with metabolic syndrome.All of them completed the physical examination, laboratory tests, assessment of cognitive function scale and the P300 test. Results There were significant differences in blood glucose, HBA1c, systolic blood pressure, BMI, waist circumference and triglyceride among the three groups(P<0.05). Compared with the patients with diabetes and hypertension, patients with metabolic syndrome had lower scores in digital memory tests, visual spatial ability, memory and total score in the memory and executive tests(P<0.05). Also the patients with metabolic syndrome had significant delayed P300 latencies than those with diabetes or hypertension(P<0.05), and decreased P300 amplitudes than diabetes group(P<0.05), but there was no significant difference compared with the hypertension group(P>0.05).Conclusion The cognitive impairment of patients with metabolic syndrome manifests itself in memory, execution, visual space, etc.,and has its own damage characteristics.The event-related potential is characterized by prolonged information processing time of the prefrontal lobe and reduced processing capacity.
Objective To explore the characteristics of cognitive impairment and the characteristics of EEG changes in patients with metabolic syndrome. Methods Totally 96 patients hospitalized between May 2017 and May 2018 were included in this study.Among them, there were 34 patients with type 2 diabetes, 20 patients with hypertension, and 42 patients with metabolic syndrome.All of them completed the physical examination, laboratory tests, assessment of cognitive function scale and the P300 test. Results There were significant differences in blood glucose, HBA1c, systolic blood pressure, BMI, waist circumference and triglyceride among the three groups(P<0.05). Compared with the patients with diabetes and hypertension, patients with metabolic syndrome had lower scores in digital memory tests, visual spatial ability, memory and total score in the memory and executive tests(P<0.05). Also the patients with metabolic syndrome had significant delayed P300 latencies than those with diabetes or hypertension(P<0.05), and decreased P300 amplitudes than diabetes group(P<0.05), but there was no significant difference compared with the hypertension group(P>0.05).Conclusion The cognitive impairment of patients with metabolic syndrome manifests itself in memory, execution, visual space, etc.,and has its own damage characteristics.The event-related potential is characterized by prolonged information processing time of the prefrontal lobe and reduced processing capacity.
引文
[1]祝之明.代谢综合征病因探索与临床实践[M].北京:人民军医出版社,2005:590.
[2]周训美,祝之明.代谢手术治疗代谢综合征[J].实用老年医学,2017,31(6):506-509.
[3]Detection Evaluation and Treatment of High Blood Cholesterol in Adults EP.Executive Summary of The Third report of The National Cholesterol Education Program(NCEP)expert panel on detection,evaluation,and treatment of high blood cholesterol in adults(Adult Treatment Panel III)[J].JAMA,2001,285(19):2486-2497.
[4]魏景汉,罗跃嘉.事件相关电位原理与技术[M].北京:科学出版社,2010:206.
[5]Biessels GJ,Staekenborg S,Brunner E,et al.Risk of dementia in diabetes mellitus:a systematic review[J].Lancet Neurol,2006,5(1):64-74.
[6]Groeneveld O,Reijmer Y,Heinen R,et al.Brain imaging correlates of mild cognitive impairment and early dementia in patients with type 2 diabetes mellitus[J].Nutr Metab Cardiovasc Dis,2018,28(12):1253-1260.
[7]Bangen KJ,Werhane ML,Weigand AJ,et al.Reduced regional cerebral blood flow relates to poorer cognition in older adults with type 2diabetes[J].Front Aging Neurosci,2018,10:270.
[8]Shah NS,Vidal JS,Masaki K,et al.Midlife blood pressure,plasma betaamyloid,and the risk for Alzheimer disease:the Honolulu Asia Aging Study[J].Hypertension,2012,59(4):780-786.
[9]徐晓娅,郭晓聪,黄琳明,等.高血压病患者血管性轻度认知功能障碍的认知损害特点及危险因素分析[J].中外医学研究,2018,16(12):55-57.
[10]Solas M,Milagro FI,Ramirez MJ,et al.Inflammation and gut-brain axis link obesity to cognitive dysfunction:plausible pharmacological interventions[J].Curr Opin Pharmacol,2017,37:87-92.
[11]Sripetchwandee J,Chattipakorn N,Chattipakorn SC.Links between obesity-induced brain insulin resistance,brain mitochondrial dysfunction,and dementia[J].Front Endocrinol(Lausanne),2018,9:496.
[12]Coomans CP,Geerling JJ,Guigas B,et al.Circulating insulin stimulates fatty acid retention in white adipose tissue via KATP Channel activation in the central nervous system only in insulin sensitive mice[J].J Lipid Res,2011,52(9):1712-1722.
[13]Chen X,Chen W,Chen SR,et al.Event-related potentials P300 in type2 diabetes mellitus[J].Di Yi Jun Yi Da Xue Bao,2003,23(3):257-259.
[14]Kurita A,Katayama K,Mochio S.Neurophysiological evidence for altered higher brain functions in NIDDM[J].Diabetes Care,1996,19(4):360-364.
[15]刘忠玲,李华.高血压患者大脑认知功能与蒙特利尔认知评估及P300的相关性研究[J].中华高血压杂志,2013,21(7):700.
[16]Tascilar ME,Turkkahraman D,Oz O,et al.P300 auditory event-related potentials in children with obesity:is childhood obesity related to impairment in cognitive functions?[J].Pediatr Diabetes,2011,12(7):589-595.
[17]易峰,苏旭江,毛静宇,等.精神分裂症伴发高脂血症的事件相关电位P300特征[J].中国健康心理学杂志,2013,21(3):321-323.
[2]周训美,祝之明.代谢手术治疗代谢综合征[J].实用老年医学,2017,31(6):506-509.
[3]Detection Evaluation and Treatment of High Blood Cholesterol in Adults EP.Executive Summary of The Third report of The National Cholesterol Education Program(NCEP)expert panel on detection,evaluation,and treatment of high blood cholesterol in adults(Adult Treatment Panel III)[J].JAMA,2001,285(19):2486-2497.
[4]魏景汉,罗跃嘉.事件相关电位原理与技术[M].北京:科学出版社,2010:206.
[5]Biessels GJ,Staekenborg S,Brunner E,et al.Risk of dementia in diabetes mellitus:a systematic review[J].Lancet Neurol,2006,5(1):64-74.
[6]Groeneveld O,Reijmer Y,Heinen R,et al.Brain imaging correlates of mild cognitive impairment and early dementia in patients with type 2 diabetes mellitus[J].Nutr Metab Cardiovasc Dis,2018,28(12):1253-1260.
[7]Bangen KJ,Werhane ML,Weigand AJ,et al.Reduced regional cerebral blood flow relates to poorer cognition in older adults with type 2diabetes[J].Front Aging Neurosci,2018,10:270.
[8]Shah NS,Vidal JS,Masaki K,et al.Midlife blood pressure,plasma betaamyloid,and the risk for Alzheimer disease:the Honolulu Asia Aging Study[J].Hypertension,2012,59(4):780-786.
[9]徐晓娅,郭晓聪,黄琳明,等.高血压病患者血管性轻度认知功能障碍的认知损害特点及危险因素分析[J].中外医学研究,2018,16(12):55-57.
[10]Solas M,Milagro FI,Ramirez MJ,et al.Inflammation and gut-brain axis link obesity to cognitive dysfunction:plausible pharmacological interventions[J].Curr Opin Pharmacol,2017,37:87-92.
[11]Sripetchwandee J,Chattipakorn N,Chattipakorn SC.Links between obesity-induced brain insulin resistance,brain mitochondrial dysfunction,and dementia[J].Front Endocrinol(Lausanne),2018,9:496.
[12]Coomans CP,Geerling JJ,Guigas B,et al.Circulating insulin stimulates fatty acid retention in white adipose tissue via KATP Channel activation in the central nervous system only in insulin sensitive mice[J].J Lipid Res,2011,52(9):1712-1722.
[13]Chen X,Chen W,Chen SR,et al.Event-related potentials P300 in type2 diabetes mellitus[J].Di Yi Jun Yi Da Xue Bao,2003,23(3):257-259.
[14]Kurita A,Katayama K,Mochio S.Neurophysiological evidence for altered higher brain functions in NIDDM[J].Diabetes Care,1996,19(4):360-364.
[15]刘忠玲,李华.高血压患者大脑认知功能与蒙特利尔认知评估及P300的相关性研究[J].中华高血压杂志,2013,21(7):700.
[16]Tascilar ME,Turkkahraman D,Oz O,et al.P300 auditory event-related potentials in children with obesity:is childhood obesity related to impairment in cognitive functions?[J].Pediatr Diabetes,2011,12(7):589-595.
[17]易峰,苏旭江,毛静宇,等.精神分裂症伴发高脂血症的事件相关电位P300特征[J].中国健康心理学杂志,2013,21(3):321-323.
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