diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/2072-0351-5535diaendo-5535Research ArticleСтатьиArticlesГоспитальная динамика показателей нейропсихологического статуса у пациентов с сахарным диабетом 2 типа, перенесших коронарное шунтированиеNeuropsychological dynamics in patients with type 2 diabetes mellitus undergone coronary artery bypass graftingТрубниковаОльга АлександровнаTrubnikovaOlga Alexandrovna

к.м.н., зав. лабораторией нейрососудистой патологии отдела мультифокального атеросклероза

olgalet17@mail.ruМамонтоваАнастасия СергеевнаMamontovaAnastasia Sergeevna

лаборант-исследователь лаборатории нейрососудистой патологии отдела мультифокального атеросклероза

olgalet17@mail.ruСыроваИрина ДаниловнаSyrovaIrina Danilovna

м.н.с. лаборатории нейрососудистой патологии

olgalet17@mail.ruМалеваОльга ВалерьевнаMalevaOlga Valer'evna

аспирант

olgalet17@mail.ruБарбарашОльга ЛеонидовнаBarbarashOlga Leonidovna

д.м.н., проф., директор

olgalet17@mail.ruФГБУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation201215122012154№4 (2012)3338Copyright © Трубникова О.А., Мамонтова А.С., Сырова И.Д., Малева О.В., Барбараш О.Л., 20122012Трубникова О.А., Мамонтова А.С., Сырова И.Д., Малева О.В., Барбараш О.Л.Trubnikova O.A., Mamontova A.S., Syrova I.D., Maleva O.V., Barbarash O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/5535Цель

Цель. Изучить госпитальную динамику показателей нейропсихологического статуса у пациентов с ишемической болезнью сердца и сопутствующим сахарным диабетом 2 типа (СД2), перенесших коронарное шунтирование в условиях искусственного кровообращения.

Материалы и методы

Материалы и методы. Обследовано 37 пациентов, из них 14 - с СД2. В предоперационном периоде у пациентов с СД2 наблюдались более низкие показатели внимания.

Результаты

Результаты. На 7-10-е сутки после операции у всех пациентов параметры когнитивных функций снизились, а у больных СД2 - в большей степени; это касалось показателей внимания, памяти, скорости сенсомоторных реакций и количества совершаемых ошибок при выполнении тестов по сравнению с пациентами без нарушения углеводного обмена.

Заключение

Заключение. Пациенты с СД2 по сравнению с пациентами без СД на госпитальном этапе имеют более низкие когнитивные показатели, что позволяет отнести их в группу повышенного риска развития прогрессирования когнитивных нарушений.

AIM

AIM: The study was aimed at evaluation of hospital neuropsychological dynamics in ischemic heart disease patients with comorbid type 2 diabetes mellitus (T2DM) undergone on-pump coronary artery bypass grafting.

MATERIALS AND METHODS

MATERIALS AND METHODS: 14 from a total of 37 examined patients had T2DM. Diabetic patients were found to have lower attention parameters prior to the intervention in comparison to non-diabetic controls. At days 7-10 after the surgery all patients demonstrated deterioration of cognitive functions.

RESULTS

RESULTS: We observed deeper deterioration in diabetic patients, regarding attention, memory, sensorimotor speed and quantity of erroneous test responses, as measured against individuals with normal glucose tolerance.

CONCLUSIONS

CONCLUSIONS: Diabetic patients undergone coronary artery bypass surgery show lower cognitive characteristics when compared to controls without T2DM, suggesting this cohort to be a high-risk group for further cognitive decline.

ишемическая болезнь сердцасахарный диабет 2 типанейропсихологический статускоронарное шунтированиеischemic heart diseasetype 2 diabetes mellitusneuropsychological statuscoronary artery bypass surgeryReferencesAkchurin RS, Shiryaev AA. Aktual'nye problemy koronarnoy khirurgii. M: GEOTAR-Media; 2004. 88p. (in Russ.)Akchurin RS, Shiryaev AA. Aktual'nye problemy koronarnoy khirurgii. M: GEOTAR-Media; 2004. 88p. (in Russ.)Bokeriya LA, Kamchatnov PR, Klyuchnikov IV, Alaverdyan AG, Gusev EI. Cerebrovascular disorders in patients with coronary bypass surgery. Neuroscience and Behavioral Physiology. 2008; 108(3): 90-94. (in Russ.)Bokeriya LA, Kamchatnov PR, Klyuchnikov IV, Alaverdyan AG, Gusev EI. Cerebrovascular disorders in patients with coronary bypass surgery. Neuroscience and Behavioral Physiology. 2008; 108(3): 90-94. (in Russ.)Bronster D. Neurologic complications of cardiac surgery: current concepts and recent advances. Curr Cardiol Rep. 2006 Feb;8(1):9-16.Bronster D. Neurologic complications of cardiac surgery: current concepts and recent advances. Curr Cardiol Rep. 2006 Feb;8(1):9-16.Postnov VG, Karas'kov AM, Lomivorotov VV. Nevrologiya v kardiokhirurgii: rukovodstvo dlya vrachey. Novosibirsk: Sibregion-info; 2007. 255p. (in Russ.)Postnov VG, Karas'kov AM, Lomivorotov VV. Nevrologiya v kardiokhirurgii: rukovodstvo dlya vrachey. Novosibirsk: Sibregion-info; 2007. 255p. (in Russ.)Browne SM, Halligan PW, Wade DT, Taggart DP. Postoperative hypoxia is a contributory factor to cognitive impairment after cardiac surgery. J Thorac Cardiovasc Surg. 2003 Oct;126(4):1061-1064.Browne SM, Halligan PW, Wade DT, Taggart DP. Postoperative hypoxia is a contributory factor to cognitive impairment after cardiac surgery. J Thorac Cardiovasc Surg. 2003 Oct;126(4):1061-1064.McKhann GM, Grega MA, Borowicz LM Jr, Bailey MM, Barry SJ, Zeger SL, Baumgartner WA, Selnes OA. Is there cognitive decline 1 year after CABG? Comparison with surgical and nonsurgical controls. Neurology. 2005 Oct 11;65(7):991-999. Epub 2005 Aug 17.McKhann GM, Grega MA, Borowicz LM Jr, Bailey MM, Barry SJ, Zeger SL, Baumgartner WA, Selnes OA. Is there cognitive decline 1 year after CABG? Comparison with surgical and nonsurgical controls. Neurology. 2005 Oct 11;65(7):991-999. Epub 2005 Aug 17.Levin OS. Diagnostika i lechenie dementsii v klinicheskoy praktike. Moscow: Medpress-inform; 2009. 255p.Levin OS. Diagnostika i lechenie dementsii v klinicheskoy praktike. Moscow: Medpress-inform; 2009. 255p.Newman SP, Harrison MJ. Coronary-artery bypass surgery and the brain: persisting concerns. Lancet Neurol. 2002 Jun;1(2):119-125.Newman SP, Harrison MJ. Coronary-artery bypass surgery and the brain: persisting concerns. Lancet Neurol. 2002 Jun;1(2):119-125.Shnayder NA. Postoperative cognitive dysfunction. Nevrologicheskiy zhurnal. 2005;10(4):37-43. (in Russ.)Shnayder NA. Postoperative cognitive dysfunction. Nevrologicheskiy zhurnal. 2005;10(4):37-43. (in Russ.)Jensen BØ, Rasmussen LS, Steinbrüchel DA. Cognitive outcomes in elderly high-risk patients 1 year after offpump versus on-pump coronary artery bypass grafting. A randomized trial. Eur J Cardiothorac Surg. 2008 Nov;34(5):1016-1021. Epub 2008 Sep 7.Jensen BØ, Rasmussen LS, Steinbrüchel DA. Cognitive outcomes in elderly high-risk patients 1 year after offpump versus on-pump coronary artery bypass grafting. A randomized trial. Eur J Cardiothorac Surg. 2008 Nov;34(5):1016-1021. Epub 2008 Sep 7.Mozalev AS. Mozgovoy krovotok i kognitivnye rasstroystva pri operatsiyakh na serdtse [Dissertation]: Avtoref. dis. … kand. med. nauk. Moscow; 2009. 25p.Mozalev AS. Mozgovoy krovotok i kognitivnye rasstroystva pri operatsiyakh na serdtse [Dissertation]: Avtoref. dis. … kand. med. nauk. Moscow; 2009. 25p.Nooyens AC, Baan CA, Spijkerman AM, Verschuren WM. Type 2 diabetes and cognitive decline in middle-aged men and women. Diabetes Care. 2010 Sep;33(9):1964-1969.Nooyens AC, Baan CA, Spijkerman AM, Verschuren WM. Type 2 diabetes and cognitive decline in middle-aged men and women. Diabetes Care. 2010 Sep;33(9):1964-1969.Levin OS. Kognitivnye narusheniya u bol'nykh sakharnym diabetom 2 tipa. Effektivnaya farmakologiya v endokrinologii. 2010;(3):58-63. [Russian]Levin OS. Kognitivnye narusheniya u bol'nykh sakharnym diabetom 2 tipa. Effektivnaya farmakologiya v endokrinologii. 2010;(3):58-63. [Russian]Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-1053.Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-1053.Charlesworth DC, Likosky DS, Marrin CA, Maloney CT, Quinton HB, Morton JR, Leavitt BJ, Clough RA, O'Connor GT; Northern New England Cardiovascular Disease Study Group. Development and validation of a prediction model for strokes after coronary artery bypass grafting. Ann Thorac Surg. 2003 Aug;76(2):436-443.Charlesworth DC, Likosky DS, Marrin CA, Maloney CT, Quinton HB, Morton JR, Leavitt BJ, Clough RA, O'Connor GT; Northern New England Cardiovascular Disease Study Group. Development and validation of a prediction model for strokes after coronary artery bypass grafting. Ann Thorac Surg. 2003 Aug;76(2):436-443.Kadoi Y, Goto F. Factors associated with postoperative cognitive dysfunction in patients undergoing cardiac surgery. Surg Today. 2006;36(12):1053-1057.Kadoi Y, Goto F. Factors associated with postoperative cognitive dysfunction in patients undergoing cardiac surgery. Surg Today. 2006;36(12):1053-1057.Bunatyan AA, Trekova NA. Rukovodstvo po kardioanesteziologii. Moscow: MIA; 2005. 688 p. (in Russ.)Bunatyan AA, Trekova NA. Rukovodstvo po kardioanesteziologii. Moscow: MIA; 2005. 688 p. (in Russ.)Ivanov VI, Litvinova NA, Berezina MG. Avtomatizirovannyy kompleks dlya individual'noy otsenki individual'notipologicheskikh svoystv i funktsional'nogo sostoyaniya organizma cheloveka «STATUS PF». Valeologiya. 2004;(4): 70-73. (in Russ.)Ivanov VI, Litvinova NA, Berezina MG. Avtomatizirovannyy kompleks dlya individual'noy otsenki individual'notipologicheskikh svoystv i funktsional'nogo sostoyaniya organizma cheloveka «STATUS PF». Valeologiya. 2004;(4): 70-73. (in Russ.)Strachan MW, Reynolds RM, Frier BM, Mitchell RJ, Price JF. The relationship between type 2 diabetes and dementia. Br Med Bull. 2008;88(1):131-146.Strachan MW, Reynolds RM, Frier BM, Mitchell RJ, Price JF. The relationship between type 2 diabetes and dementia. Br Med Bull. 2008;88(1):131-146.Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006 Jan;5(1):64-74.Biessels GJ, Staekenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006 Jan;5(1):64-74.Miyoshi S, Morita T, Kadoi Y, Goto F. Analysis of the factors related to a decrease in jugular venous oxygen saturation in patients with diabetes mellitus during normothermic cardiopulmonary bypass. Surg Today. 2005;35(7):530-534.Miyoshi S, Morita T, Kadoi Y, Goto F. Analysis of the factors related to a decrease in jugular venous oxygen saturation in patients with diabetes mellitus during normothermic cardiopulmonary bypass. Surg Today. 2005;35(7):530-534.Nötzold A, Michel K, Khattab AA, Sievers HH, Hüppe M Diabetes mellitus increases adverse neurocognitive outcome after coronary artery bypass grafting surgery. Thorac Cardiovasc Surg. 2006 Aug;54(5):307-312.Nötzold A, Michel K, Khattab AA, Sievers HH, Hüppe M Diabetes mellitus increases adverse neurocognitive outcome after coronary artery bypass grafting surgery. Thorac Cardiovasc Surg. 2006 Aug;54(5):307-312.

The authors declare that there are no conflicts of interest present.