本文選題：血管性癡呆 + 血清雌二醇��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2013年碩士論文

【摘要】：背景 血管性癡呆一組由各種腦血管病所引起認(rèn)知損害為主的綜合征,病因復(fù)雜,危害嚴(yán)重,早期可防治。目前關(guān)于雌激素對認(rèn)知功能的作用,研究結(jié)果不一致。石杉堿甲是一種可逆性膽堿酯酶抑制劑,通過多種途徑提高腦內(nèi)的乙酰膽堿的水平和功能,研究發(fā)現(xiàn)乙酰膽堿的變化對體內(nèi)性腺軸產(chǎn)生一定影響,關(guān)于石杉堿甲是否影響血管性癡呆患者雌二醇(estradiol, E2)水平國內(nèi)外無相關(guān)的研究報道。 目的 1、探討老年男性血管性癡呆患者血清雌二醇水平。 2、探討老年男性血管性癡呆患者血清E2水平與認(rèn)知功能的關(guān)系。 3、探討石杉堿甲對老年男性血管性癡呆患者認(rèn)知功能及血清E2水平的影響。 方法 1、選擇98例符合NINDS-AIREN診斷標(biāo)準(zhǔn)的血管性癡呆患者(VD組)作為研究對象,用年齡與研究組匹配的無認(rèn)知障礙腦血管病患者(腦血管病組)60例及健康老年人60例(正常組)作為對照。 2、VD組隨機(jī)分為VD研究組和VD對照組,各49例,VD研究組在基礎(chǔ)治療基礎(chǔ)上加服石杉堿甲(150μg,每日兩次),連續(xù)服用3個月；VD對照組只給予基礎(chǔ)治療3個月。 3、使用簡易精神狀態(tài)量表(Mini-Mental State Examination, MMSE)和維迪Keypiont4通道誘發(fā)電位儀測定各研究對象治療前以及治療3個月后MMSE得分、事件相關(guān)電位P300(event-related potentials P300, ERP-P300)(?)勺潛伏期及波幅。 4、利用全自動電化學(xué)發(fā)光免疫分析系統(tǒng)測定各組治療前及VD組治療3個月后血清E2水平。 5、所有數(shù)據(jù)均經(jīng)SPSS16.0統(tǒng)計軟件包進(jìn)行處理。用x2檢驗比較各組間文化程度差異；用F檢驗比較VD組、腦血管病組、正常組E2水平、MMSE得分、P300潛伏期及波幅的差異；用t檢驗比較VD組E2水平、MMSE得分、P300潛伏期及波幅差異,用Pearson相關(guān)分析法分析VD組治療前、后E2水平、MMSE得分、P300潛伏期及波幅各測量值間的相互關(guān)系。所有檢驗均為雙側(cè)檢驗,以P0.05為差異有顯著意義。 結(jié)果 1、VD組血清E2水平高于腦血管病組及正常組(F=64.170,P=0.000)；腦血管病組血清E2水平高于正常組(P0.01)。 2、VD組P300潛伏期較腦血管病組及正常組延長(F=92.944,P=0.000)：VD組P300波幅低于腦血管病組及正常組(F=47.766,P=0.000)。與正常組相比,腦血管病組P300潛伏期延長(P0.01),P300波幅降低(P0.05),差異有統(tǒng)計學(xué)意義。 3、相關(guān)分析顯示：VD組血清E2水平與MMSE得分呈負(fù)相關(guān)(r=—0.432,P=0.000),與P300潛伏期呈正關(guān)聯(lián)(r=0.334,P=0.001),與P300波幅無關(guān)聯(lián)(r=—0.194,P=0.055)：MMSE得分與P300潛伏期呈負(fù)相關(guān)(r=—0.309,P=0.002)。 4、治療3個月后,VD研究組MMSE得分較治療前升高(t=3.337,P=0.001),也較VD對照組高(t=3.736,P=0.000)；VD研究組P300潛伏期較治療前縮短(t=2.653,P=0.010),也較VD對照組短(t=2.098,P=0.038)；VD研究組P300波幅治療前后無統(tǒng)計學(xué)意義(P0.05),與VD對照組相比也無統(tǒng)計學(xué)意義(P0.05)；VD對照組MMSE、P300潛伏期及波幅較3個月前相比均無統(tǒng)計學(xué)意義(P0.05)。 5、治療3個月后,VD研究組血清E2水平無明顯變化(t=1.495,P=0.140),VD對照組血清E2水平也無明顯變化(t=0.542,P=0.590)。 6、VD研究組治療后相關(guān)分析顯示：VD研究組血清E2水平差值與MMSE得分差值、P300潛伏期差值及波幅差值均無關(guān)聯(lián)(r=—0.119、0.160、0.227,P=0.417、0.273、0.117)：MMSE得分差值與P300潛伏期差值呈負(fù)相關(guān)(r=—0.357,P=0.012)。 結(jié)論 1、老年男性血管性癡呆患者血清E2水平較非認(rèn)知障礙腦血管病患者和健康老年人明顯升高,高水平的E2可能對老年男性血管性癡呆患者認(rèn)知功能具有一定的不良影響。 2、石杉堿甲對改善老年男性血管性癡呆患者的認(rèn)知功能有一定的意義,對老年男性血管性癡呆患者血清E2水平無明顯影響。
[Abstract]:background
The syndrome of vascular dementia by a group of various cerebrovascular disease caused by cognitive impairment mainly causes complex, serious harm, early prevention. The effects of estrogen on the cognitive function, the results are not consistent. Huperzine A is a reversible acetylcholinesterase inhibitor, improve the level and function of brain acetylcholine through a variety of ways, the study found that acetylcholine changes have a certain impact on the in vivo gonadal axis of huperzine A is affected in patients with vascular dementia estradiol (estradiol, E2) - related research reports at home and abroad.
objective
1, to investigate the level of serum estradiol in senile male patients with vascular dementia.
2, to investigate the relationship between the level of serum E2 and cognitive function in elderly male patients with vascular dementia.
3, the effect of huperzine A on cognitive function and serum E2 level in elderly male patients with vascular dementia was investigated.
Method
1, 98 patients with vascular dementia (group VD) who met the diagnostic criteria of NINDS-AIREN were selected as the subjects. 60 patients without cerebrovascular disease (cerebrovascular disease) matched with the study group and 60 healthy elderly patients (normal group) were used as controls.
2, VD group was randomly divided into VD research group and VD control group, 49 cases in each group. The VD research group added huperzine A (150 g, two times a day) on the basis of basic treatment, and continued to take 3 months. VD control group only received basic treatment for 3 months.
3, using the Mini Mental State Scale (Mini-Mental State Examination, MMSE) and "Keypiont4 channel determination of evoked potential instrument subjects before treatment and 3 months after treatment MMSE score, event-related potential P300 (event-related potentials P300, ERP-P300) (?) the latency and amplitude.
4, the serum levels of E2 were measured by the automatic electrochemiluminescence immunoassay system before and after treatment in group VD for 3 months.
5, all the data were processed by SPSS16.0 statistical software package. Using x2 test to compare the group differences between cultures; VD were compared with F test, cerebrovascular disease group and normal group E2 level, MMSE score, the difference in P300 latency and amplitude; compare the level of E2 in group VD was tested with T, MMSE, P300 the latency and amplitude difference analysis using Pearson correlation analysis method of VD group before treatment, E2 level, MMSE score, P300 latency and amplitude of the measured value of the relation. All tests were two-sided test, P0.05 showed significant difference.
Result
1, the level of serum E2 in the group VD was higher than that of the cerebrovascular disease group and the normal group (F=64.170, P=0.000), and the serum E2 level of the cerebrovascular disease group was higher than that of the normal group (P0.01).
2, VD group P300 latency cerebrovascular disease group and normal group (F=92.944, P=0.000) extended:VD group P300 were below the cerebrovascular disease group and normal group (F=47.766, P=0.000). Compared with the normal group, the cerebrovascular disease group (P0.01), P300 latency and amplitude of P300 decreased (P0.05), there was statistical significance the difference.
3, correlation analysis showed that the serum E2 level in VD group was negatively correlated with MMSE score (r= - 0.432, P=0.000), positively correlated with P300 latency (r=0.334, P=0.001), and was not correlated with P300 amplitude (r= - 0.194, P=0.055). There was a negative correlation between the score of incubation and latent period of incubation (0.309 - 0.309).
4, after 3 months of treatment, VD MMSE scores of study group were increased compared with before treatment (t=3.337, P=0.001), compared with VD control group (t=3.736, P=0.000); VD group P300 latency reduced than those before treatment (t=2.653, P=0.010), compared with VD control group (t=2.098, P=0.038); VD. The group P300 was statistical significance before and after treatment (P0.05), compared with the VD control group had no statistical significance (P0.05); VD control group MMSE, P300 latency and amplitude is compared to 3 months ago had no statistical significance (P0.05).
5, after 3 months of treatment, there was no significant change in serum E2 level in VD study group (t=1.495, P=0.140), and there was no significant change in serum E2 level in VD control group (t=0.542, P=0.590).
6, according to VD correlation analysis of the study group after treatment VD group, serum E2 level and MMSE score difference, P300 latency and amplitude difference values are not related (r= 0.119,0.160,0.227, P=0.417,0.273,0.117):MMSE score was negatively correlated with P300 latency difference (r= 0.357, P=0.012).
conclusion
1, serum E2 level in elderly male patients with vascular dementia is significantly higher than that in non cognitive impairment, cerebrovascular disease and healthy elderly. High level of E2 may have some adverse effects on cognitive function in elderly men with vascular dementia.
2, huperzine A has a certain significance in improving cognitive function in elderly men with vascular dementia, but has no significant effect on serum E2 level in elderly men with vascular dementia.

【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.16

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