Characteristics And Risk Factors Of Vascular Cognitive Impairment In Patients With Acute Cerebral Infarction And Type 2 Diabetes Mellitus

Objective:To investigate the characteristics of vascular cognitive impairment in patients with acute cerebral infarction and type 2 diabetes mellitus and the related risk factors of vascular cognitive impairment.Methods: 1.To collect 146 cases of acute cerebral infarction with type 2 diabetes diagnosed by Department of Neurology,First Affiliated Hospital of Xinjiang Medical University from December 2017 to June 2018.The onset time was within one week.PSD(post stroke depression)was excluded according to ICD.10 F32 diagnostic criteria for depression.Gender,age,smoking,educational years,duration of diabetes,history of hypertension were collected.General information such as atrial fibrillation and past medical history should be registered,and relevant examinations such as glycosylated hemoglobin,homocysteine,head CT and head MRI(including diffusion imaging)should be improved.The Beijing version of Montreal Cognitive Assessment Scale(MoCA)was improved within one week of onset,and its total scores and scores were recorded.According to the diagnostic criteria of vascular cognitive impairment(VCI)in the Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment,the patients were divided into two groups: VCI group(82 cases)and normal cognitive group(64 cases).2.To analyze the scoring characteristics of each item in MoCA scale of acute cerebral infarction with type 2 diabetes mellitus and calculate the incidence of VCI.3.Univariate analysis was made on sex,age,smoking,education,diabetes course,glycosylated hemoglobin,history of hypertension,atrial fibrillation,homocysteine and leukoaraiosis in VCI and non-VCI groups to determine whether there were statistical differences between the two groups.4.Further multivariate analysis of the statistical differences of the results of single factor analysis,using VCI as a strain,and introducing multivariate unconditional logistic regression analysis model to analyze the risk factors associated with VCI.Results: 1.The scores of visual space and executive ability,naming ability,attention,computational ability,linguistic ability,delayed recall ability,directional ability and abstract thinking dimension of MoCA scale in patients with acute cerebral infarction and type 2 diabetes mellitus were lower than the standard scores(P< 0.05),especially visual space and executive ability,computational ability,Abstract thinking,directional ability and delayed recall ability.Low.Within one week of onset,the incidence of vascular cognitive impairment(VCI)was 56.2%.2.Univariate analysis: univariate analysis showed that education years,hypertension and leukoaraiosis had statistical significance in cognitive dysfunction group compared with normal cognitive function group,with P value less than 0.05;glycosylated hemoglobin,course of diabetes and hyperhomocysteinemia had significant statistical significance between two groups with or without cognitive dysfunction,with P value less than 0.01.3.Multivariate analysis: years of education(OR = 0.853,95% confidence interval 0.715-0.989),hypertension(OR = 2.674,OR = 2.674,95% confidence interval 1.108-6.882),glycated hemoglobin(OR = 1.394,95% confidence interval 1.394,95% confidence interval 1.117-1.752),duration of diabetes(OR=1.309,95% confidence interval 1.026-1.681),hyperhomocysteinemia(OR = 6.472,95% confidence interval 0.472,95 95% confidence interval 1.102-36.426),white matter relaxed brain(OR = 5.296,There were significant differences between the 6 variables above 95% confidence interval(1.805-28.625)(p < 0.05).Conclusion:1.The scores of visual space and executive ability,naming ability,attention,computational ability,language ability,delayed recall ability,orientation and abstract thinking ability of MoCA in patients with acute cerebral infarction and type 2 diabetes mellitus were lower than the standard scores(P<0.05).Among them,visual space and executive ability,computational ability,Abstract thinking,orientation and delayed recall ability were all lower than the standard scores(P<0.05).The incidence of cognitive impairment was 56.2%.2.Multivariate analysis of risk factors of acute cerebral infarction with type 2 diabetes mellitus showed that hypertension,hyperhomocysteinemia,glycosylated hemoglobin,course of diabetes mellitus and leukoaraiosis may be risk factors for VCI in patients with type 2 diabetes mellitus(T2DM)and acute cerebral infarction.Educational years are the protective factors.