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目的:观察胰岛素缓解帕金森病合并糖尿病患者认知功能障碍的效果。方法:选择临床确诊的帕金森病合并2型糖尿病128例,随机分为观察组与对照组各64例;观察组采用甘精胰岛素联合二甲双胍治疗,对照组采用单纯二甲双胍治疗。分别于治疗前、治疗后6个月和12个月采用蒙特利尔认知评估量表(MoCA)和临床疗效总评量表(CGI),评估并比较两组认知功能障碍变化情况。结果:(1)观察组治疗前MoCA评分(21.2±2.7)分,治疗6个月及12个月时分别为(21.0±2.5)分和(20.7±3.1)分;对照组治疗前MoCA评分(21.0±3.4)分,治疗6个月及12个月时分别为(19.7±1.9)分和(18.3±2.2)分;对照组治疗6个月及12个月时MoCA评分均显著低于观察组同时间节点(P<0.05)。(2)观察组治疗6个月及12个月时CGI评分分别恶化6例(9.4%)和11例(17.2%),均显著低于对照组的17例(26.6%)和23例(35.9%)(P<0.05)。结论:胰岛素能够有效延缓帕金森病合并糖尿病患者认知功能的下降。
Objective: To observe the effect of insulin on cognitive dysfunction in patients with Parkinson’s disease and diabetes mellitus. Methods: 128 patients with clinically diagnosed Parkinson’s disease complicated with type 2 diabetes mellitus were randomly divided into observation group and control group with 64 cases each. The observation group was treated with insulin glargine combined with metformin and the control group with metformin alone. The Montreal Cognitive Assessment Scale (MoCA) and Clinical Curative Effect Rating Scale (CGI) were used before treatment, 6 months and 12 months after treatment to evaluate and compare the changes of cognitive dysfunction between the two groups. Results: (1) The score of MoCA in observation group before treatment (21.2 ± 2.7) was (21.0 ± 2.5) and (20.7 ± 3.1) at 6 and 12 months respectively. The MoCA score 21.0 ± 3.4). The scores of MoCA at 6 months and 12 months were (19.7 ± 1.9) and (18.3 ± 2.2) points respectively. The MoCA scores of the control group at 6 and 12 months were significantly lower than those of the observation group The same time node (P <0.05). (2) The CGI scores of the observation group were significantly lower than those of the control group (6.6%) and 11 cases (17.2%) at 6 and 12 months respectively %) (P <0.05). Conclusion: Insulin can effectively delay the decline of cognitive function in patients with Parkinson’s disease and diabetes mellitus.