·糖尿病神经病变·

　　王亭亭 贾志荣 潘涛 王洪霞 石盺 梁为

　　作者单位：100034北京，北京大学第一医院神经内科

　　通讯作者：贾志荣

　　【摘要】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。

　　【关键词】糖尿病，2型;脑缺血;认知障碍; P300

　　doi:10.3969/j.issn.1006-6187.2012.01.010

　　Changes in P300 in type 2 diabetic patients with versus without cerebral ischemia WANG Ting-ting，JIA Zhi-rong， PAN Tao， et al. Department of Neurology, The First Hospital of Peking University, Beijing 100034, China

　　Corresponding author: JIA Zhi-rong

　　【Abstract】ObjectiveTo investigate the cognitive function in elderly type 2 diabetic patients with versus without cerebral ischemia.Methods62 patients with type 2 diabetes mellitus(DM) were divided into DM with cerebral ischemia (CI)group(35 cases)and DM without cerebral ischemia group(35 cases) by CT scan.Audio event-related potentials(P300) was measured in above groups and 30 matched normal control. The latency period (Lat) and the amplitude (Amp) were detected.ResultsThe average Lat of P300 in DM without CI was (388.17±39.2)ms while that in DM with CI was (400.27±52.32)ms ,which was longer than in normal control group(359.27±37.16)ms(P<0.01).The average Amp of P300 in DM[(7.2±3.95)mV]and DM with CI[(5.83±2.31)mV]was lower than the normal control group[(7.84±3.57)mV] (P<0.01).The Amp was longer in DM with CI than in DM (P<0.01).Multivariate analysis showed that cerebral ischemia influenced the latency period of P300 at most. There was a negative correlation between the course of the DM and the amplitude of P300(P<0.05),while there was a positive correlation between the course of DM and the latency of P300(P<0.05). ConclusionsThe type 2 diabetic patients have cognitive impairment，and cerebral ischemia may exacerbate the cognitive impairment. P300 can be a sensitive index in early diagnosis and dynamic monitoring of cognitive impairment in elderly individuals with type 2 diabetes.

　　【Key words】Diabetes,type 2; Cerebral ischemia;Cognitive impairment; P300