中文摘要：

目的探讨2型糖尿病（diabetes mellitus,DM）患者认知功能特征及其与血浆脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）水平的关系。方法应用多维度神经心理学量表评估年龄及教育程度相匹配的89例2型DM患者及40例对照者的神经认知功能,并结合Peterson的遗忘型轻度认知功能障碍（amnesic mildcognitive impairment,aMCI）标准判定两组中的aMCI患者;采用酶联免疫吸附试验检测血浆BDNF水平。结果 2型DM组连线测试B（trial marking test B,TMTB）、听觉词语记忆测试-延迟回忆和再认（delayed recall and recogni-tion of auditory verbal learning test,AVLT-DR＆RC）、符号数字转换测试（symbol digit modulation test,SDMT）,词语流畅性测试（verbal fluency test,VFT）及画钟测试（clock drawing test,CDT）成绩均明显差于对照组（均P〈0.01）;2型DM与aMCI有较强的关联性[OR=4.032（1.536~10.582）],2型DM中aMCI者AVLT-DR＆RC、VFT、TMTB、CDT、连线测试A（trial marking test A,TMTA）、复杂图形测试-延迟回忆（delayed recall of Rey-Osterrich complex figure test,CFT-DR）成绩均明显差于2型DM非aMCI组（P〈0.05）;2型DM组血浆BDNF水平明显低于对照组（P〈0.01）,但与各项认知评估成绩无相关性（P〉0.05）,仅2型DM组aMCI者血浆BDNF水平与SDMT及CFT-DR测试成绩呈正相关（分别为r=0.522,P〈0.01;r=0.346,P〈0.05）。结论 2型DM患者可出现认知功能损伤,并伴血浆BDNF水平降低;但2型DM的认知功能改变与BDNF水平之间的关系有待进一步研究证实。

英文摘要：

Objective The aims of this study were to investigate the characteristics of cognitive function in patients with type 2 diabetes（DM）and the association of the cognitive function in type 2 DM patients with plasma levels of brain-derived neurotrophic factor（BDNF）.Methods Eighty-nine patients with type 2 DM and 40 nondiabetic controls with age and education matched were included in this study.All the subjects received a set of multi-dimension neuropsychologic tests for the cognitive assessment,and the diagnoses of amnesic mild cognitive impairment（aMCI）were made mainly according to the results of cognitive assessment and the criteria of aMCI by Peterson.An enzyme-linked immunosorbent assay（ELISA）was used to measure plasma BDNF concentrations.Results The performances of type 2 DM group in the trial marking test B（TMT B）,the delayed recall and recognition of auditory verbal learning test（AVLT-DRRC）,the symbol digit modulation test（SDMT）,verbal fluency test（VFT）and clock drawing test（CDT）were obviously worse than those of controls group（P0.01）.Type 2 DM has a strong association with aMCI（OR 95%CI=1.536~10.582,χ2=8.769,P=0.003）.In type 2 DM group,patients with aMCI had significantly lower scores of AVLT-DRRC,VFT,TMT B,CDT,Trial marking test A（TMT A）and delayed recall of Rey-Osterrich complex figure test（CFT-DR）,compared to patients without aMCI.The plasma levels of BDNF in type 2 DM group was significantly lower than those in controls group（P0.01）.But there was no correlation between plasma levels of BDNF and scores of each neuropsychological test in type 2 DM group.The plasma levels of BDNF were positively correlation with the scores of DSMT and CFT-DR（r=0.522,P0.01;r=0.346,P0.05）only in type 2 DM patients with aMCI.Conclusions Patients with type 2 DM prone to have cognitive impairments and a lower plasma level of BDNF.However,the association between cognitive function in patients with type 2 DM and the levels of BDNF remain to be confirmed.