MemTrax在线工具在社区老年糖尿病认知功能筛查中的应用价值

朱文奎; 刘炜; 徐群; 钱雅慧; 俆绮

doi:10.16766/j.cnki.issn.1674-4152.003297

MemTrax在线工具在社区老年糖尿病认知功能筛查中的应用价值

doi: 10.16766/j.cnki.issn.1674-4152.003297

朱文奎¹,
刘炜²,
徐群³,
钱雅慧¹,
俆绮^2, ,

1.
上海市浦东新区沪东社区卫生服务中心检验科，上海 200129
2.
上海市浦东新区沪东社区卫生服务中心全科，上海 200129
3.
上海市交通大学医学院附属仁济医院神经内科，上海 200127

基金项目:

上海市浦东新区卫生健康委员会卫生计生科研项目 PW2021A-81

上海市自然科学基金项目 23ZR1439200

详细信息

通讯作者:
徐绮，E-mail: xuqi08@126.com

中图分类号: R587.1
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出版历程
- 收稿日期: 2023-04-27
- 网络出版日期: 2024-01-29

The significance of MemTrax in screening mild cognitive impairment in elderly diabetes patients in community

ZHU Wenkui¹,
LIU Wei²,
XU Qun³,
QIAN Yahui¹,
XU Qi^{2
, ,}

1.
Department of Clinical Laboratory, Hudong Community Health Service Center of Shanghai Pudong New Area, Shanghai 200129, China

摘要

摘要: 目的探讨运用在线记忆认知评估系统MemTrax(MTX)对社区老年糖尿病认知功能筛查的意义，为临床推广提供依据。方法于2022年9—10月选取上海市某社区家庭医生签约服务对象中纳入糖尿病慢病管理的老年糖尿病患者89例及非糖尿病患者62例为研究对象，收集所有研究对象的一般临床资料，同时采集静脉血检测空腹血糖(FPG)、血肌酐、血清尿素氮、尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白，运用MTX在线工具测定正确率和反应时间。采用Spearman相关分析研究MTX正确率、反应时间与FPG、糖化血红蛋白、糖尿病病程的相关性，采用多因素logistic回归分析探究MTX正确率结果异常的影响因素。结果老年糖尿病组和对照组MTX正确率分别为78%(72%，82%)、82%(78%，88%)。Spearman相关分析显示，MTX正确率与FPG、糖化血红蛋白、糖尿病病程呈负相关关系，相关系数分别为-0.301、-0.393、-0.291。多因素logistic回归分析结果显示，年龄和糖尿病为MTX正确率异常的影响因素，OR值分别为0.902(95% CI为0.830~0.980)、3.523(95% CI为1.681~7.383)。结论糖尿病相关指标与MTX正确率密切相关，糖尿病为MTX正确率异常的影响因素，运用MTX正确率对社区老年糖尿病认知功能筛查有一定的价值。
- 老年糖尿病 /
- MemTrax测试 /
- 认知功能障碍 /
- 上海市 /
- Spearman相关分析
Abstract: Objective To explore the relevance of using the MemTrax (MTX) online cognitive memory assessment system for screening diabetes in older people in the community, providing a basis for clinical promotion. Methods From September to October 2022, 89 elderly diabetic patients and 62 non-diabetic patients, including the management of diabetic chronic diseases, were selected as research subjects from the service targets contracted by family doctors in a community in Shanghai, Collected general clinical data from all study subjects, At the same time, venous blood was collected for fasting plasma glucose(FPG), creatinine, serum urea nitrogen, uric acid, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin, and the MTX online tool was used to determine the correct rate and reaction time. Spearman correlation analysis was used to analyze the relationship between MTX accuracy, reaction time and FPG, glycosylated hemoglobin and diabetes outcome. Multifactor logistic regression analysis was used to explore the factors associated with abnormal MTX accuracy results. Results The correct rate of MTX was 78% (72%, 82%) and 82% (78%, 88%) in the elderly diabetes group and control group, respectively; Spearman correlation analysis showed that the correct rate of MTX was negatively correlated with FPG, glycosylated hemoglobin, and diabetes course, and the correlation coefficients were -0.301, -0.393, and -0.291, respectively. Multivariate logistic regression analysis showed that the OR values of age and diabetes as risk factors for abnormal MTX accuracy were 0.902 (95% CI: 0.830-0.980), 3.523 (95% CI: 1.681-7.383). Conclusion Diabetes-related indicators are closely related to the accuracy of MTX, diabetes is a risk factor for abnormal accuracy of MTX, and the use of MTX accuracy has some value in community screening of elderly diabetes cognitive function.
- Elderly diabetes /
- MemTrax test /
- Cognitive dysfunction /
- Shanghai city /
- Spearman correlation analysis

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表 1 老年糖尿病组和对照组的基本资料和实验室检查结果比较

Table 1. Comparing basic data and laboratory test between the elderly diabetes group and the control group

组别	例数	性别[例(%)]		年龄 (x±s，岁)	教育程度 (x±s，年)	吸烟史[例(%)]			饮酒[例(%)]
组别	例数	男性	女性	年龄 (x±s，岁)	教育程度 (x±s，年)	无	有		无	有
对照组	62	16(25.8)	46(74.2)	70.97±5.06	10.46±3.05	52(83.9)	10(16.1)		50(80.6)	12(19.4)
老年糖尿病组	89	34(38.2)	55(61.8)	71.94±4.95	10.41±3.16	73(82.0)	16(18.0)		75(84.3)	14(15.7)
统计量		2.535^a		1.118^b	0.098^b	0.088^a			0.337^a
P值		0.111		0.239	0.920	0.767			0.562

组别	例数	高血压[例(%)]			冠心病[例(%)]		ALT (x±s，U/L)	UREA (x±s，mmol/L)		Cr (x±s，μmol/L)
组别	例数	无	有		无	有	ALT (x±s，U/L)	UREA (x±s，mmol/L)		Cr (x±s，μmol/L)
对照组	62	21(33.9)	41(66.1)		45(72.6)	17(27.4)	19.32±10.68	5.09±1.15		72.21±16.21
老年糖尿病组	89	19(21.3)	70(78.7)		64(71.9)	25(28.1)	23.25±11.10	5.22±1.46		72.96±19.53
统计量		2.943^a			0.008^a		2.170^b	0.557^b		0.247^b
P值		0.095			0.999		0.032	0.579		0.805

组别	例数	UA [M(P₂₅, P₇₅)，μmol/L]		CHOL [M(P₂₅, P₇₅)，mmol/L]		TRIG (x±s，mmol/L)	HDL-C [M(P₂₅, P₇₅)，mmol/L]	LDL-C [M(P₂₅, P₇₅)，mmol/L]
对照组	62	342.00(290.00，409.00)		5.10(4.50，6.00)		1.38±0.58	1.43(1.23，1.58)	2.91(2.45，3.78)
老年糖尿病组	89	352.00(296.00，414.00)		4.80(4.10，5.60)		1.53±0.73	1.27(1.12，1.51)	2.76(2.29，3.25)
统计量		-0.225^c		-2.097^c		-1.312^b	2.396^c	-1.891^c
P值		0.822		0.036		0.191	0.018	0.059
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 老年糖尿病组和对照组MTX测试结果比较[M(P₂₅, P₇₅)]

Table 2. Results of MTX test in elderly diabetes group and control group[M(P₂₅, P₇₅)]

组别	例数	正确率(%)	反应时间(s)
对照组	62	82(78，88)	1.19(1.01，1.37)
老年糖尿病组	89	78(72，82)	1.26(1.02，1.44)
Z值		3.485	0.403
P值		< 0.001	0.687

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表 3 糖尿病指标及病程与MTX指标的相关性分析

Table 3. Correlation analysis of diabetes indicators, disease duration, and MTX indicators

项目	MTX正确率(%)		MTX反应时间
项目	r(rs)值	P值	r(rs)值	P值
FPG	-0.301	< 0.001	0.106	0.195
糖化血红蛋白	-0.393	< 0.001	0.035	0.674
糖尿病病程	-0.291	0.006	-0.048	0.656

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表 4 MTX正确率异常影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis assessing the impact of cognitive risk factors on MTX test results

变量	B	SE	Wald χ²	P值	OR(95% CI)
年龄	-0.103	0.042	5.975	0.015	0.902(0.830~0.980)
性别	0.259	4.14	0.391	0.532	1.295(0.576~2.914)
教育程度	0.174	0.140	1.533	0.216	1.190(0.904~1.567)
冠心病	0.224	0.400	0.313	0.576	1.251(0.571~2.741)
高血压	0.174	0.424	0.168	0.682	1.190(0.518~2.733)
糖尿病	1.259	0.377	11.133	0.001	3.523(1.681~7.383)
注：logistic回归分析变量赋值如下，性别(男性=1，女性=0)；冠心病(是=1，否=0)；高血压(是=1，否=0)；糖尿病(是=1，否=0)；年龄和教育程度为连续变量，以实际值赋值。

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