| 陆之瑾,刘乙蒙,李美燕,马倩文,赵璞,李晓雨,闻杰,吴慧慧,万静,许天蕴.小剂量秋水仙碱对老年糖尿病合并高尿酸血症患者轻度认知障碍的影响[J].老年医学与保健,2026,32(3):407-411 |
| 小剂量秋水仙碱对老年糖尿病合并高尿酸血症患者轻度认知障碍的影响 |
| Effects of low-dose colchicine on mild cognitive impairment in elderly patients with diabetes mellitus complicated with hyperuricemia |
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| DOI：10.3969/j.issn.1008-8296.2026.03.015 |
| 中文关键词: 秋水仙碱 糖尿病 高尿酸血症 轻度认知障碍 |
| 英文关键词: colchicine diabetes mellitus hyperuricemia mild cognitive impairment |
| 基金项目:20214Y0245:上海市卫生健康委员会科研项目 |
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| 中文摘要: |
| 目的 探讨小剂量秋水仙碱对老年糖尿病合并高尿酸血症患者轻度认知障碍的影响.方法 收集并筛选2022 年 1 月至2023 年12 月于上海市静安区中心医院内分泌科收治的老年糖尿病合并高尿酸血症和轻度认知功能障碍患者共101 例.采用随机数字表法将其分为秋水仙碱组51 例和对照组50 例,研究过程中共脱落17 例,最终共84 例(秋水仙碱组42 例、对照组42 例)完成全部治疗及随访并纳入统计分析,比较2 组患者治疗前后的认知功能和代谢指标的变化.结果 秋水仙碱组(0.5 mg/d)患者治疗1 年后简易智力状态检查量表评分升高约1.4 分,蒙特利尔认知评估量表评分升高约2.4 分,阿尔茨海默病评定量表-认知量表评分降低约4.5 分(P<0.05),对照组各认知量表评分变化呈相反趋势,且治疗前后组内差异无统计学意义.治疗后2 组间上述认知量表评分差异有统计学意义(P<0.05),而临床痴呆评定量表、汉密尔顿抑郁量表及工具性日常活动能力量表评分无显著差异;代谢及炎症指标方面,秋水仙碱组患者治疗后血尿酸和糖化血红蛋白水平较治疗前显著改善,炎症因子白细胞介素-1β、肿瘤坏死因子-α 水平较治疗前显著降低(均 P<0.05);白细胞介素-6、C-反应蛋白水平虽较治疗前有所下降,但差异无统计学意义.对照组仅血尿酸水平较治疗前显著降低(P<0.05),其余代谢及炎症指标治疗前后无明显变化.治疗后组间比较显示,秋水仙碱组白细胞介素-1β、肿瘤坏死因子-α 水平显著低于对照组(P<0.05).结论 小剂量秋水仙碱可改善糖尿病合并高尿酸血症老年患者的轻度认知障碍. |
| 英文摘要: |
| Objective To investigate the effects of low-dose colchicine on mild cognitive impairment(MCI)in elderly patients with diabetes mellitus(DM)complicated with hyperuricemia(HUA).Methods A total of 101 elderly patients with DM complicated with HUA and MCI admitted to Department of Endocrinology,Central Hospital of Jing'an District,Shanghai,from January 2022 to December2023,were enrolled and screened.They were randomly divided into colchicine group(n=51)and control group(n=50)using a random number table.During the study,17 patients were lost to follow-up,resulting in a final 84 patients(42 in the colchicine group and 42 in the control group)who completed all treatment and follow-ups and were included in the statistical analysis.The changes in cognitive function and metabolic indicators were compared between the two groups before and after treatment.Results After one year of treatment with colchicine(0.5 mg/day),the colchicine group showed an increase of approximately 1.4 points on the mini-mental state examination and 2.4 points on the Montreal cognitive assessment,along with a decrease of approximately 4.5 points on the Alzheimer's disease assessment scale-cognitive subscale(P<0.05).In contrast,the control group exhibited opposite trends in these cognitive scale scores,with no statistically significant within-group differences before and after treatment.Between-group comparisons after treatment revealed statistically significant differences in the above-mentioned cognitive scale scores(P<0.05),whereas no significant differences were observed in the clinical dementia rating,Hamilton depression rating scale,or instrumental activities of daily living scores.Regarding metabolic and inflammatory indicators,the colchicine group demonstrated significant improvements in serum uric acid and glycated hemoglobin levels from baseline to post-treatment,as well as significant reductions in the inflammatory cytokines interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)(all P<0.05);interleukin-6(IL-6)and C-reactive protein levels also decreased after treatment,but the differences did not reach statistical significance.In the control group,only serum uric acid level decreased significantly after treatment(P<0.05),with no significant changes in the other metabolic or inflammatory indicators.Post-treatment intergroup comparisons showed that IL-1β and TNF-α levels in the colchicine group were significantly lower than those in the control group(P<0.05).Conclusion Low-dose colchicine can improve mild cognitive impairment in elderly patients with DM and HUA. |
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