本文選題：堿性磷酸酶　切入點(diǎn)：腦缺血　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 通過比較皮質(zhì)下缺血性血管病(SIVD)患者和正常對照組的血清堿性磷酸酶(ALP)水平及認(rèn)知功能評分結(jié)果,探討ALP變化及其對認(rèn)知功能的影響,并分析其中可能的機(jī)制。方法 收集158例就診于安徽醫(yī)科大學(xué)第一附屬醫(yī)院的SIVD患者,依據(jù)認(rèn)知損害程度分為皮質(zhì)下血管性輕度認(rèn)知損害組(SVMCI,n=86)及皮質(zhì)下血管性癡呆組(SVa D,n=72),選擇67名認(rèn)知功能正常的老年人作為對照組。依據(jù)頭顱MRI將SIVD分為多發(fā)性腔隙性腦梗死組(LI)、腦白質(zhì)疏松組(LA),并對LA程度進(jìn)行分級。收集所有受試者空腹8h的靜脈血,通過全自動(dòng)分析儀測定血清ALP水平,并按照其濃度將受試者均分為1組(ALP71 U/L)、2組(ALP 71~86 U/L)和3組(ALP86 U/L);采用簡易精神狀態(tài)檢查(MMSE)及劍橋老年認(rèn)知檢查表-中國修訂版(CAMCOG-C)等量表對認(rèn)知功能進(jìn)行評價(jià)。比較不同認(rèn)知損害程度組間血清ALP水平,不同ALP濃度間LI、LA及認(rèn)知損害發(fā)生率,并將認(rèn)知功能評分與ALP等進(jìn)行相關(guān)分析和多元回歸分析。結(jié)果 (1)SIVD患者受教育年限低于對照組;高血壓、吸煙比例,血清尿素氮水平均高于對照組;SVa D、SVMCI患者血清ALP水平均顯著高于對照組,3組間差異具有統(tǒng)計(jì)學(xué)意義(均P0.05)。(2)SVa D和SVMCI患者M(jìn)MSE及CAMCOG-C評分均低于對照組,且SIVD患者CAMCOG-C各子項(xiàng)評分(包括定向、語言、記憶、注意、執(zhí)行、計(jì)算、思維、知覺)也顯著低于對照組,差異均具有統(tǒng)計(jì)學(xué)意義(均P0.05)。(3)將受試者ALP濃度按照三等分法均分為3組:1組(ALP71U/L)、2組(ALP 71~86 U/L)和3組(ALP86 U/L),每組均為75例,3組之間LI、LA及SVa D發(fā)生率差異具有統(tǒng)計(jì)學(xué)意義(χ2=8.008,P=0.018;χ2=17.998,P=0.000;χ2=12.255,P=0.002),結(jié)果顯示隨著血清ALP水平升高,其LI、LA及SVa D發(fā)生率均逐漸升高。(4)相關(guān)分析發(fā)現(xiàn),ALP與MMSE、CAMCOG-C總分呈負(fù)相關(guān)(r=-0.350,P=0.000;r=-0.286,P=0.000);且ALP與CAMCOG-C評分子項(xiàng)中定向、語言、記憶、注意、執(zhí)行、計(jì)算、思維、知覺等均呈負(fù)相關(guān)(r=-0.193,P=0.004;r=-0.238,P=0.000;r=-0.273,P=0.000;r=-0.261,P=0.000;r=-0.222,P=0.001;r=-0.210,P=0.002;r=-0.218,P=0.001;r=-0.161,P=0.015)。(5)多元回歸分析在校正年齡、性別、吸煙、高血壓等相關(guān)因素后,ALP與認(rèn)知功能損害呈正相關(guān),在控制變量中添加LA分級后,ALP與認(rèn)知損害無明顯相關(guān)性,提示血清ALP對SIVD患者認(rèn)知功能的影響與LA嚴(yán)重程度密切相關(guān)。結(jié)論 校正性別、年齡及體重指數(shù)等因素后,SVMCI組和SVa D組血清ALP水平、高血壓及吸煙比例等血管危險(xiǎn)因素均高于對照組。SVMCI和SVa D組MMSE、CAMCOG-G及其各子項(xiàng)評分均顯著低于對照組�？刂颇挲g、性別、吸煙、高血壓等相關(guān)因素后,血清ALP水平與認(rèn)知功能損害呈正相關(guān),尤其是腦白質(zhì)疏松較為嚴(yán)重者。
[Abstract]:Objective to compare the subcortical ischemic vascular disease (SIVD) patients and normal control group, serum alkaline phosphatase (ALP) level and cognitive function score results, to explore the changes of ALP and its effects on cognitive function, and analyze its possible mechanism. Methods 158 patients from the First Affiliated Hospital of Medical University Of Anhui from SIVD patients, according to cognitive impairment the degree of subcortical vascular mild cognitive impairment group (SVMCI, n=86) and subcortical vascular dementia group (SVa D, n=72), selected 67 elderly normal cognitive function as the control group. According to the head MRI SIVD is divided into multiple lacunar infarction group (LI), cerebral white matter osteoporosis group (LA), and classification of LA. Venous blood samples were collected from all subjects fasting 8h, serum ALP levels were measured by automatic analyzer, and in accordance with the concentration of the subjects were divided into 1 groups (ALP71, U/L) group (ALP 71~86 U/L 2 ) and 3 group (ALP86 U/L); with the mini mental state examination (MMSE) and Cambridge cognitive examination - China Revised Edition (CAMCOG-C) scale to evaluate the cognitive function. Comparison of different levels of cognitive impairment between the serum level of ALP, different concentrations of ALP between LA and LI, and the incidence of cognitive impairment. The score of cognitive function and ALP for correlation analysis and multiple regression analysis. Results (1) patients with SIVD years of education than in the control group; the proportion of hypertension, smoking, serum urea nitrogen and water were higher than the control group; SVa, D, ALP in serum SVMCI level were significantly higher than the control group, the difference was statistically significant between the 3 groups (all P0.05). (2) SVa D and SVMCI in patients with MMSE and CAMCOG-C scores were lower than the control group, SIVD and CAMCOG-C in patients with sub item score (including orientation, language, memory, attention, executive, calculation, thinking, perception) is significantly lower than the control group, the differences were statistically 鎰忎箟(鍧嘝0.05).(3)灝嗗彈璇曡，

本文編號：1608421