糖尿病神经病变·

　　【摘要】 目的 观察普罗布考对T2DM合并轻度认知功能障碍(MCI)患者改善的情况。 方法 根据蒙特利尔认知评估北京版(MoCA)量表结果选取糖尿病合并MCI(MoCA<26分)患者88例，随机分为治疗组46例与对照组42例。干预6个月，比较治疗前后两组认知功能(MoCA评分)、β淀粉样蛋白40(Aβ1-40)和颈动脉内-中膜厚度(CIMT)的差异。 结果 两组完成随访人数分别为42例和40例。治疗后，治疗组Aβ1-40较对照组降低[135.05(35.32，221.23) vs 174.15(85.13，327.77) pg/ml，P<0.01]，两组治疗后MoCA评分差异无统计学意义。两组治疗前后临床参数自身差值(Δ=治疗前-治疗后)比较，差异均有统计意义[ΔMoCA：-4.00(-5.00，-2.00) vs -1(-3.00，0.00)，P<0.01;ΔAβ1-40：68.61(-58.59，198.76) vs 9.00(-110.65，106.67) pg/ml，P=0.02);ΔCIMT：0.05(-0.05，0.20) vs -0.05(-0.10，0.10) mm，P=0.02]。 结论 普罗布考可降低T2DM合并MCI患者Aβ1-40水平，改善认知功能。

　　【关键词】 糖尿病，2型;轻度认知功能障碍;普罗布考;颈动脉内-中膜厚度;蒙特利尔认知评估

　　　【Abstract】 Objective To evaluate the effects of probucol on cognitive function improvement in type 2 diabetic patients with MCI. Methods 88 patients with MCI were selected by the results of the montreal cognitive assessment Beijing edition (MoCA) and divided into treatment group(n=46) and control group (n=42). After being intervened for 6 months, MoCA scores, Aβ1-40, and CIMT were assessed between before and after treatment. Results 42 patients in treatment group and 40 patients in control group were completed the follow-up. After six months therapy, the levels of Aβ1-40 in treatment group were lower than in control group[135.05(35.32,221.23) vs 174.15(85.13,327.77) pg/ml,P<0.01].There was no significant difference in MoCA between two groups. However, there were significant difference in the levels of ΔAβ1-40, ΔMoCA, and ΔCIMT between two groups[ΔMoCA：-4.00(-5.00，-2.00) vs -1(-3.00，0.00)，P<0.01;ΔAβ1-40：68.61(-58.59，198.76) vs 9.00(-110.65，106.67) pg/ml，P=0.02);ΔCIMT：0.05(-0.05，0.20) vs -0.05(-0.10，0.10) mm，P=0.02]. Conclusions Probulcol intervention therapy may reduce levels of Aβ1-40 and improve the cognitive function in type 2 diabetic patients with MCI.

　　【Key words】 Diabetes mellitus, type 2; Mild cognitive impairment; Probucol; Carotid intima-media thickness; Montreal cognitive assessment