| Objective: To explore the incidence and related risk factors of Vascular cognitive impairrment not dementia(VCIND) through collecting and analyzing basic information and related factors of inpatients with Diabetes mellitus type 2(T2DM) and Acute cerebral infarction. Method:1. We selected 96 hospitalized patients of the Department of Neurology at the Second Affiliated Hospital of Dalian Medical University from April 2013 to October 2014, who were diagnosed with T2 DM and Acute cerebral infarction(2 weeks from onset), excluded of Post stroke depression(PSD) according to ICD-10 F32 depression diagnostic criteria. Collecting the general conditions, biochemical examinations, carotid duplex ultrasound and imageological examinations of the patients. Inquiring and recording the screening evaluation results of Montreal Cognitive Assessment(Mo CA) Beijing version. The patients were divided into two groups, VCIND group(n=66) and the normal group(n=30), according to classification and diagnostic criteria of “Guidelines for diagnosis and treatment of Vascular cognitive impairment” formulated by dementia and cognitive impairment group of neurology branch of the Chinese medical association. Analyzing the incidence and related risk factors of VCI.2. Calculate the incidence of VCIND in inpatients with T2 DM and acute cerebral infarction.3. Univariate analysis between groups with and without VCIND, analyze the possible risk factors.(1) General conditions: gender, age, degree of education.(2) Biological factors: Fasting blood-glucose(FBG), 2h Postprandial plasma glucose, Hemoglobin A1c(Hb A1c), diabetes duration, usage of insulin, urine protein, body mass index, hypertension, carotid artery atherosclerosis, artial fibrillation.(3) Imaging characteristics: the number of cerebral infarction lesion, the locality of cerebral infarction(left or right cerebral hemisphere, cortical to subcortical infarction or subcortical infarction), leukoaraiosis and degree of leukoaraiosis.Analyze the factors mentioned above to make sure whether or not there were statistical differerces between the two groups.4. Introduce factors with statistical differences of univariate analysis into multivariate unconditional Logistic regression analysis model, take VCIND as dependent variable, learn about the possible independent risk factors that related to VCIND.Results:1. The incidence of VCIND in inpatients with T2 DM and Acute cerebral infarction(2 weeks from onset) was 68.75%.2. Univariate analysis:(1) Compared with the normal group, the mean degree of education is lower in VCIND group, the difference between the two groups was statistically significant(P=0.047, P<0.05).(2) Between the two group, FBG had no statistically significant difference(P=0.425, P>0.05); 2h Postprandial plasma glucose had no statistically significant difference(P=0.635, P>0.05); Hb A1 c had statistically significant differences(P=0.000, P<0.01); urine protein had statistically significant differences(P=0.008, P<0.01).(3) Compared with the normal group, the mean diabetes duration is longer in VCIND group, the difference between the two groups was statistically significant(P=0.001, P<0.01).(4) Compared with the normal group, the number of patients using insulin is less in VCIND group, the difference between the two groups was statistically significant(P =0.029, P<0.05).(5) Compared with the normal group, the number of the lesion of left cerebral hemisphere is more in VCIND group, the difference between the two groups was statistically significant(P=0.001, P<0.01).(6) Compared with the normal group, the number of the cortical to subcortical infarction is more in VCIND group, the difference between the two groups was statistically significant(P=0.009, P<0.01).(7) Compared with the normal group, the number of acute cerebral infarcts is more than that in VCIND group, the difference between the two groups was statistically significant(P=0.017, P<0.05).(8) Compared with the normal group, the number of leukoaraiosis is more in VCIND group, the difference between the two groups was statistically significant(P=0.006, P<0.01).(9) Compared with the normal group, the degree of leukoaraiosis is severer in VCIND group, the difference between the two groups was statistically significant(P=0.046, P<0.05).3. Multivariate Logistic regression analysis showed that, the degree of education(OR=0.801, 95%CI 0.653-0.982), Hb A1c(OR=1.391, 95%CI 1.212-1.727), diabetes duration(OR=1.316, 95%CI 1.029-1.684), urine protein(OR=7.198, 95%CI 1.133-45.748), lesions of left cerebral hemisphere(OR=19.630, 95%CI 3.041-126.703), cortical to subcortical infarction(OR=9.708, 95%CI 1.415-66.607), and leukoaraiosis(OR=4.902, 95%CI 1.022-23.524) were independent risk factors of VCIND.Conclusion:1. The incidence of VCIND in inpatients with T2 DM and Acute cerebral infarction was 68.75%.2. The lower the degree of education was, the higher the incidence of VCI was in inpatients with T2 DM and Acute cerebral infarction.3. Univariate analysis showed that higher level of Hb A1 c, longer diabetes duration, non usage of insulin, urine protein were the related risk factors of VCIND in inpatients with T2 DM and Acute cerebral infarction.4. Univariate analysis showed that infarction of left cerebral hemisphere, cortical to subcortical infarction, more lesions of cerebral infarcion, leukoaraiosis, severer leukoaraiosis were the related risk factors of VCIND in inpatients with T2 DM and Acute cerebral infarction.5. Multivariate Logistic regression analysis showed that education years, Hb A1 c, diabetes duration, urine protein, infarction of left cerebral hemisphere, cortical to subcortical infarction, and leukoaraiosis were possibly the independent risk factors of VCIND in inpatients with T2 DM and Acute cerebral infarction. |
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