本文選題：阿爾茨海默病 + 有氧運(yùn)動(dòng)��； 參考：《南京醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的：通過(guò)觀察早期阿爾茨海默病(Alzheimer's disease, AD)患者在有氧運(yùn)動(dòng)訓(xùn)練前后認(rèn)知功能、精神行為癥狀、生活自理能力的改善,評(píng)價(jià)有氧運(yùn)動(dòng)對(duì)早期AD患者的干預(yù)作用,同時(shí)分析事件相關(guān)電位N200、P300波幅和潛伏期以及生化指標(biāo)在訓(xùn)練前后的變化情況,為臨床選擇合適的AD治療效果評(píng)估工具提供參考。方法;采用隨機(jī)數(shù)字表法將門診招募的60例阿爾茨海默病患者隨機(jī)分成30例有氧運(yùn)動(dòng)組和30例對(duì)照組。運(yùn)動(dòng)組給予每周三次,每次40分鐘,持續(xù)三個(gè)月的有氧運(yùn)動(dòng)訓(xùn)練。有氧運(yùn)動(dòng)為江蘇省人民醫(yī)院康復(fù)科編制的一套有氧運(yùn)動(dòng)操,經(jīng)過(guò)檢測(cè)其強(qiáng)度符合中等強(qiáng)度,即運(yùn)動(dòng)訓(xùn)練過(guò)程中的心率達(dá)到最大心率的70%。三個(gè)月訓(xùn)練結(jié)束后以及六個(gè)月隨訪過(guò)程中分別對(duì)有氧運(yùn)動(dòng)組及對(duì)照組進(jìn)行認(rèn)知量表評(píng)估、生化檢查和事件相關(guān)電位的檢查。認(rèn)知量表評(píng)估主要包括簡(jiǎn)易精神狀態(tài)量表(Minimum Mental State Examination, MMSE),阿爾茨海默病認(rèn)知功能評(píng)估量表(Alzheimer's Disease Assessment Scale-cognition, ADAS-cog),阿爾茨海默病日常生活能力評(píng)估量表(Alzheimer's Disease Cooperative Study-Activities of Daily Living, ADCS-ADL),神經(jīng)精神科量表(the Neuropsychiatric Inventory, NPI),阿爾茨海默病生活質(zhì)量量表(Quality of Life in Alzheimer's Disease, Qol-AD)。生化檢查包括膽固醇、甘油三酯、高密度脂蛋白以及低密度脂蛋白。事件相關(guān)電位檢查主要包括P300和N200的潛伏期、波幅(基峰值和峰峰值)。結(jié)果：有氧運(yùn)動(dòng)訓(xùn)練前,運(yùn)動(dòng)組和對(duì)照組在年齡、性別、受教育程度和MMSE分值上均無(wú)明顯差異。在認(rèn)知量表評(píng)估方面：三個(gè)月訓(xùn)練后,運(yùn)動(dòng)組MMSE, ADCS-ADL分值均較基線明顯增高(P0.05),但和六個(gè)月的評(píng)估相比沒(méi)有差異；三個(gè)月訓(xùn)練后,ADAS-cog, NPI分值較基線明顯降低(P0.05),和六個(gè)月的評(píng)估相比也沒(méi)有差異；Qol-AD分值在三個(gè)月訓(xùn)練后、六個(gè)月隨訪與基線比較均無(wú)明顯差異；相關(guān)性分析顯示運(yùn)動(dòng)組ADAS-cog分值變化與ADCS-ADL分值變化呈負(fù)相關(guān),對(duì)照組MMSE, ADAS-cog, ADCS-ADL, NPI, Qol-AD分值在訓(xùn)練后、隨訪與基線相比均無(wú)明顯差異。在生化指標(biāo)方面：運(yùn)動(dòng)組與對(duì)照組在訓(xùn)練后、隨訪與基線相比TC、TG、HDL, LDL值均無(wú)明顯差異。在事件相關(guān)電位方面：運(yùn)動(dòng)組P300潛伏期在三個(gè)月訓(xùn)練后和六個(gè)月隨訪均較基線有明顯降低(P0.05),六個(gè)月的隨訪與三個(gè)月相比也有明顯降低(P0.05),P300基峰值在三個(gè)月和六個(gè)月之后均較基線有明顯增高(P0.05),三個(gè)月和六個(gè)月比較未見(jiàn)明顯差異,峰峰值在六個(gè)月與基線比較有明顯增高(P0.05)；對(duì)照組P300潛伏期在三個(gè)月與基線比較無(wú)明顯差異,在六個(gè)月與基線比較有明顯增高(P0.05),基峰值和峰峰值在三個(gè)月和六個(gè)月與基線比較均無(wú)明顯差異。運(yùn)動(dòng)組N200潛伏期在三個(gè)月訓(xùn)練后和基線比較無(wú)明顯差異,在六個(gè)月隨訪和基線比較明顯增高(P0.05),基峰值、峰峰值在三個(gè)月和六個(gè)月隨訪與基線比較無(wú)明顯差異,對(duì)照組潛伏期、基峰值和峰峰值在三個(gè)月和六個(gè)月隨訪均較基線均無(wú)明顯差異。結(jié)論：表明有氧運(yùn)動(dòng)對(duì)早期AD患者的認(rèn)知功能、精神行為癥狀以及生活自理能力均有改善作用。P300潛伏期可以作為評(píng)價(jià)AD患者治療效果的參考指標(biāo)。
[Abstract]:Objective: To evaluate the effect of aerobic exercise on early AD patients by observing the cognitive function, mental behavior symptoms and self-care ability of early Alzheimer's disease (AD) before and after the training of aerobic exercise, and to evaluate the activity of N200, P300 amplitude and latency and biochemical index in training. The changes were provided for the clinical selection of a suitable AD therapeutic evaluation tool. Methods 60 patients with Alzheimer's disease were randomly divided into 30 aerobic exercise groups and 30 control groups. The exercise group was given 40 minutes a week, aerobic exercise for three months, and aerobic exercise. The exercise is a set of aerobic exercises for the rehabilitation department of Jiangsu Province People's Hospital. After three months of training at the middle intensity of the exercise training, the heart rate reaches the maximum heart rate of three months, and during the six month follow-up process, the aerobic exercise group and the control group are evaluated by the cognitive scale, biochemical examination and the control group, respectively. The assessment of the event related potential. The assessment of the cognitive scale included the simple mental state scale (Minimum Mental State Examination, MMSE), the cognitive function assessment scale of Alzheimer's disease (Alzheimer's Disease Assessment Scale-cognition, ADAS-cog), the assessment of the daily living ability of Alzheimer's disease (Alzheimer's Disease) Ative Study-Activities of Daily Living, ADCS-ADL), neuropsychiatric scale (the Neuropsychiatric Inventory, NPI), Alzheimer's disease quality of life scale (Quality of). Biochemical tests include cholesterol, glycerol three ester, high density lipoprotein, and low density lipoprotein. Event related potential test The investigation included the incubation period of P300 and N200, amplitude (peak value and peak peak). Results: there was no significant difference in age, sex, education and MMSE scores between the exercise group and the control group before the aerobic exercise training. In the cognitive scale evaluation, after three months of training, the scores of MMSE and ADCS-ADL were significantly higher than those of the baseline (P0.05). But there was no difference compared with the six month evaluation; after three months of training, ADAS-cog, NPI scores were significantly lower than the baseline (P0.05), and there was no difference compared with the six month evaluation. The Qol-AD score was no significant difference between the six month follow-up and the baseline after three months of training; the correlation analysis showed that the ADAS-cog score of the sports group was changed with ADCS. The change of -ADL score was negative correlation, and the score of MMSE, ADAS-cog, ADCS-ADL, NPI, Qol-AD in the control group had no significant difference compared with the baseline after training. In biochemical indexes, there was no significant difference in TC, TG, HDL, LDL values between the exercise group and the control group after the training and compared with the baseline. In the event related potential, the exercise group was P300 latency. The period after three months of training and six months follow-up were significantly lower than the baseline (P0.05). The follow-up of six months was significantly lower than that of three months (P0.05). The peak value of the P300 base was significantly higher than the baseline after three months and six months (P0.05), and there was no significant difference between three months and six months. The peak peak value was compared with the baseline for six months. There was a significant increase (P0.05). The P300 latency of the control group was not significantly different from the baseline in three months, and there was a significant increase in the baseline and baseline (P0.05) in the six months. The base peak and peak peak value were not significantly different from the baseline in three months and six months. The N200 latency of the exercise group had no significant difference between the three months after training and the baseline, in six The follow-up and baseline were significantly higher (P0.05). The base peak and peak peak value were not significantly different from the baseline in three months and six months. The latency of the control group, the base peak and peak peak value were no significant difference compared with the baseline at three months and six months. Conclusion: the cognitive function of aerobic exercise to early AD patients was shown to be spiritual. The.P300 latency can be used as a reference index for evaluating the therapeutic effect of AD patients.

【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R749.16

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