本文選題：認(rèn)知功能障礙 + 阿爾茨海默病�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析2014年1月至2017年1月年吉林大學(xué)某醫(yī)院收治的認(rèn)知功能障礙患者并進(jìn)行調(diào)查,分析認(rèn)知功能障礙相關(guān)的危險(xiǎn)因素,并推測(cè)海馬萎縮與認(rèn)知功能障礙發(fā)生及發(fā)展的相關(guān)性,為認(rèn)知功能障礙的早期發(fā)現(xiàn)及早期干預(yù)提供線索。方法:收集2014年1月至2017年1月吉林大學(xué)某醫(yī)院收治的認(rèn)知功能障礙患者并進(jìn)行分析,篩選出明確診斷為認(rèn)知功能障礙患者,共計(jì)60例,其中癡呆組46例,輕度認(rèn)知功能障礙組14例,同時(shí)采集患者的民族、性別、年齡、血壓(收縮壓)、空腹血糖、甘油三酯、低密度脂蛋白膽固醇、總膽固醇、高密度脂蛋白膽固醇、頸動(dòng)脈血管彩超、海馬萎縮程度(3.0T頭部核磁)等資料,采集患者M(jìn)MSE及MOCA量表各個(gè)子項(xiàng)目的分值,收集我科同期住院認(rèn)知功能正�；颊�60例作為對(duì)照組,并收集上述相關(guān)項(xiàng)目及所有臨床數(shù)據(jù)資料。所得數(shù)據(jù)均采用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行分析,計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用X2檢驗(yàn),指標(biāo)間關(guān)系連續(xù)變量采用PEARSON分析,分級(jí)變量采用SPEARMAN分析,危險(xiǎn)因素采用Logistic回歸分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.癡呆組、輕度認(rèn)知功能障礙組、對(duì)照組患者年齡、性別差異無(wú)統(tǒng)計(jì)學(xué)意義,三組患者受教育程度程度經(jīng)檢驗(yàn)MCI組受教育程度高于癡呆組,對(duì)照組受教育程度高于MCI組,P=0.000,有統(tǒng)計(jì)學(xué)意義。2.本研究中的患者海馬均有一定程度的萎縮,且海馬萎縮MTA分級(jí)與患者年齡呈正相關(guān),即年齡越高,MTA分級(jí)越高;與MOCA得分呈負(fù)相關(guān),即海馬萎縮越重,相應(yīng)的MOCA得分越低;與CDR得分呈正相關(guān),即海馬萎縮越重,癡呆程度也越重,與血同型半胱氨酸及頸動(dòng)脈硬化程度也呈現(xiàn)正相關(guān)。3.總體患者中各因素與MMSE/MOCA得分經(jīng)相關(guān)性分析結(jié)果顯示MMSE得分與受教育程度呈正相關(guān),MOCA得分與受教育程度呈正相關(guān),與高密度脂蛋白膽固醇水平呈正相關(guān)。4.認(rèn)知功能障礙組與糖尿病病史存在相關(guān)性,認(rèn)知功能障礙組空腹血糖(P=0.023)、低密度脂蛋白膽固醇(P=0.046)、血同型半胱氨酸(P=0.001)及頸動(dòng)脈硬化程度(P=0.019)高于非認(rèn)知功能障礙組,有顯著統(tǒng)計(jì)學(xué)意義。5.多因素Logistic回歸分析顯示低密度脂蛋白膽固醇、血同型半胱氨酸、海馬萎縮MTA分級(jí)2級(jí)(伴腦室顳角擴(kuò)大)為認(rèn)知障礙的獨(dú)立危險(xiǎn)因素,P0.05有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.認(rèn)知功能障礙患者M(jìn)OCA得分與受教育程度存在正相關(guān),表示較高的受教育程度是認(rèn)知功能障礙的保護(hù)性因素。2.海馬萎縮程度與年齡正相關(guān),與血同型半胱氨酸、頸部動(dòng)脈硬化程度存在正相關(guān)。3.認(rèn)知功能障礙與空腹血糖、是否伴有糖尿病病史、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、血同型半胱氨酸、頸部動(dòng)脈硬化程度、海馬萎縮MTA分級(jí)存在相關(guān)性。4.低密度脂蛋白、血同型半胱氨酸、伴有顳角擴(kuò)大的海馬萎縮為認(rèn)知功能障礙的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to retrospectively analyze and investigate the patients with cognitive dysfunction in a hospital of Jilin University from January 2014 to January 2017, and analyze the risk factors related to cognitive dysfunction.The correlation between hippocampal atrophy and the occurrence and development of cognitive dysfunction provides clues for early detection and early intervention of cognitive dysfunction.Methods: from January 2014 to January 2017, 60 patients with cognitive dysfunction were selected and analyzed in a hospital of Jilin University, including 46 patients with dementia.In the mild cognitive impairment group of 14 patients, the nationality, sex, age, blood pressure (systolic blood pressure, fasting blood glucose, triglyceride, low density lipoprotein cholesterol, total cholesterol, high density lipoprotein cholesterol) were collected.Carotid artery color Doppler ultrasound, hippocampal atrophy degree and 3.0T head nuclear magnetic field were used to collect the scores of the subitems of MMSE and MOCA, and 60 patients with normal cognitive function were collected as the control group.And collect the above related items and all clinical data.The data were analyzed by SPSS22.0 statistical software, the measurement data were analyzed by t test, the count data by X2 test, the continuous variables of the relationship between indexes were analyzed by PEARSON, and the graded variables were analyzed by SPEARMAN.The risk factors were significantly different by Logistic regression analysis (P 0.05).The result is 1: 1.There was no significant difference in age and sex among dementia group, mild cognitive impairment group and control group. The educational level of the three groups was higher than that of the dementia group, and the educational level of the three groups was higher than that of the dementia group.The educational level of the control group was higher than that of the MCI group.The MTA grade of hippocampal atrophy was positively correlated with the patient's age, that is, the higher the age, the higher the score of MOCA, that is, the heavier the hippocampal atrophy, the lower the corresponding MOCA score.There was a positive correlation with CDR score, that is, the more severe the hippocampus atrophy, the more severe the dementia, and the positive correlation with homocysteine and carotid arteriosclerosis.The results of correlation analysis showed that there was a positive correlation between MMSE score and education level and a positive correlation between MMSE score and education level, and a positive correlation between MMSE score and high density lipoprotein cholesterol level.There was a correlation between cognitive dysfunction group and diabetic history. The levels of fasting blood glucose, low density lipoprotein cholesterol (LDL-C), plasma homocysteine (P0. 001) and carotid arteriosclerosis in cognitive dysfunction group were significantly higher than those in non cognitive dysfunction group (P 0. 023, P 0. 046, P 0. 019).There is significant statistical significance.Multivariate Logistic regression analysis showed that low density lipoprotein cholesterol (LDL-C), homocysteine (Hcy) and hippocampal atrophy (MTA grade 2) were independent risk factors for cognitive impairment (P0.05).Conclusion 1.There was a positive correlation between MOCA score and education level in patients with cognitive dysfunction, indicating that higher level of education was the protective factor of cognitive dysfunction.The degree of hippocampal atrophy was positively correlated with age, blood homocysteine and cervical arteriosclerosis.Cognitive dysfunction was correlated with fasting blood glucose, history of diabetes, low density lipoprotein cholesterol, high density lipoprotein cholesterol, homocysteine, degree of atherosclerosis in the neck, and MTA grade of hippocampal atrophy.Low density lipoprotein, homocysteine and hippocampal atrophy with temporal horn enlargement were independent risk factors for cognitive impairment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R749.1

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