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目的应用神经电生理方法,探讨T2DM伴与不伴脑缺血性病变患者认知功能的改变。方法 62例中老年T2DM患者,根据头MRI检查有无缺血病灶,将其分为单纯糖尿病组(DM组,n=35例)和糖尿病合并脑缺血性病变组(DM+CI组,n=27例)。两组患者和正常对照组(NC组,30名)均进行听觉事件相关电位P300检查。结果 DM组及DM+CI组的P300潜伏期均较NC组明显延长(P<0.01);DM组及DM+CI组的P300波幅较NC组明显降低(P<0.01)。DM+CI组的P300波幅较DM组降低(P<0.01),前者潜伏期延长,但差异无统计学意义(P>0.05)。多种因素分析,脑缺血对P300潜伏期影响最大。DM组病程与P300波幅呈负相关(P<0.05),DM组病程和P300潜伏期呈正相关(P<0.05)。结论 T2DM可引起患者认知功能损害,合并缺血性脑损害可加重患者的认知功能损害,事件相关电位P300检测可作为老年糖尿病认知损害早期诊断的客观指标。
Objective To investigate the changes of cognitive function in T2DM patients with and without cerebral ischemic lesions by using electrophysiological methods. Methods Sixty-two middle-aged and elderly patients with T2DM were divided into simple diabetic group (DM group, n = 35) and diabetes mellitus with cerebral ischemic group (DM + CI group, n = 27 cases). Two groups of patients and normal control group (NC group, 30) were performed auditory event-related potentials P300. Results The latency of P300 in DM group and DM + CI group was significantly longer than that in NC group (P <0.01). The amplitude of P300 in DM group and DM + CI group was significantly lower than that in NC group (P <0.01). The amplitude of P300 in DM + CI group was lower than that in DM group (P <0.01). The latency of P300 in DM + CI group was longer, but the difference was not statistically significant (P> 0.05). A variety of factors analysis, cerebral ischemia has the greatest impact on P300 latency. The course of DM was negatively correlated with the amplitude of P300 (P <0.05), and the duration of DM was positively correlated with the latency of P300 (P <0.05). Conclusion T2DM can cause cognitive impairment in patients with ischemic brain damage may aggravate cognitive impairment in patients with P300 detection of cognitive function as an objective indicator of early diagnosis of cognitive impairment in diabetic patients.