代谢综合征与老年血管性痴呆的相关性研究

目的探讨代谢综合征（MS）危险因素在老年血管性痴呆（VD）患者中的分布与聚集状况，为老年VD早期干预提供依据。方法对123例首次发病的年龄≥60岁的老年脑血管病患者，根据简易精神智力量表（MMSE）及美国神经精神病学第四版精神病的诊断和统计手册（DSM—iv）痴呆诊断标准确诊为VD患者40例（VD组）。根据头颅CT检查结果选出脑卒中部位。性质与之相匹配的非痴呆的脑血管病患者40例做为对照（NVD组），另自门诊及住院一般疗养的老年人中选出40例做为健康对照组。分别检测其体重指数（BMI）、血压、血脂、空腹血糖、负荷餐后2h血糖、糖化血红蛋白、胰岛素等指标。结果收缩压（SBP）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、2小时血糖（2HPG）胰岛素抵抗（HOMA—IR）在对照组、NVD组、VD组依次呈增高趋势，差异有统计学意义（P〈0．05，P〈0．01），高密度脂蛋白胆固醇（HDL—C）则呈下降趋势。SBP、2HPG、HOMA—IR在VD组与对照组相比差异非常显著（P〈0．01），VD组MS发病率与危险因素个数均明显高于对照组（P〈0．01）。结论老年VD患者存在更严重的代谢紊乱，早期干预将有助于延缓和减少痴呆的发生、发展。

Correlation Between Metabolic Syndrome and Senile Vascular Dementia

Objective To analysis the distribution and the status of aggregation of the risk factors of metabolic syndrome among senile vascular dementia patients,in order to provide the bases for early intervention for senile vascular dementia. Methods It diagnosed 123 cases of first-episode senile cerebrovascular disease patients,whose ages were older than 60. From those 123 cases,40 cases of vascular dementia （VD） were confirmed by diagnostic criteria of MMSE and DSM-iv. By the head CT report,40 non-dementia senile patients with vascular （NVD group）were selected,whose cerebral apoplectic position properties matched with those of VD group. And from the in-and-out-patients,40 elders were selected as the healthy group. It separately detected the indexes of body mass index（BMI）,blood pressure and blood lipids,fasting plasma glucose ,blood sugar after 2 hours food,glycosylated hemoglobin,insulin and so on. Results The systolic blood pressure （SBP）,triglyceride （TG）,low density lipoprotein cholesterol （LDL-C）,2-hour plasma glucose （2hPG） and insulin resistance （HOMA-IR） in the control group,NVD and VD groups sequentially presented elevating trends. There were differences between them（P〈0.05,P〈0.01）. And the high density lipoprotein cholesterol （HDL-C） presented a descending trend. Comparing SBP,2hPG and HOMA-IR in VD group with those in control group,there were obvious differences between them （P〈0.01）. The incidence of the metabolic syndrome and the number of the risk factors of VD group were both significantly higher than those of control group （P〈0.01）. Conclusions The old patients with vascular dementia have the more serious metabolism disorder. Early intervention will help to delay or reduce the occurrence and the development of the dementia.