本文選題：肌酸激酶 + 乳酸脫氫酶��； 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：分析精神分裂癥患者住院期間血清肌酸激酶和乳酸脫氫酶的改變及其相關(guān)的影響因素。 方法：收集99例精神分裂癥患者(研究組)以及101例健康人群(對照組)作為研究對象，研究組分別于入院第2天和第4周末清晨6:00-6:30采肘正中靜脈血2ml進(jìn)行心肌酶分析，對照被試采肘正中靜脈血1次，方法同上。采用陽性癥狀量表(SAPS)和陰性癥狀量表(SANS)、攻擊風(fēng)險評估表分別于研究組入院第2天和第4周末上午8:00-11:00評估疾病狀態(tài)和攻擊行為。運(yùn)用Spearman秩相關(guān)分析檢驗治療前、后CK和LDH與癥狀的相關(guān)性；運(yùn)用非參數(shù)檢驗對不同等級攻擊風(fēng)險組間CK和LDH差異比較，同時分析性別與攻擊風(fēng)險的關(guān)系；采用多重線性逐步回歸分析，分析治療前CK和LDH的影響因素。運(yùn)用Spearman秩相關(guān)分析檢驗治療前后CK和LDH變化與癥狀變化的相關(guān)性。 結(jié)果：1.治療前CK和LDH值統(tǒng)計分析：陽性癥狀組、混合癥狀組和陰性癥狀組CK和LDH差異不具有統(tǒng)計學(xué)意義（P＞0.05）。研究組CK值與對照組CK值差異具有統(tǒng)計學(xué)意義（p=0.000）。研究組與對照組LDH值之間差異不具有統(tǒng)計學(xué)意義（P＞0.05）。陽性量表總分（r=0.410，p＜0.001）、妄想綜合評價（r=0.275，p＜0.05）、陽性思維形式障礙（r=0.288，p＜0.05）與研究組CK值正相關(guān)。思維貧乏（r=-0.207，p＜0.05）與CK值負(fù)相關(guān)。陽性量表總分（r=0.351，p＜0.001）和妄想綜合評價（r=0.207，p＜0.05）與研究組LDH正相關(guān)。情感平淡遲鈍（r=-0.248，p＜0.05）與LDH值負(fù)相關(guān)。攻擊行為影響CK和LDH值。多因素逐步回歸分析顯示攻擊行為（β=0.548，P=0.000）對CK影響最大，其次次為年齡（β=-0.282，P=0.001），正常人群年齡不是CK值的影響因素。多因素逐步回歸分析顯示攻擊行為（β=0.302，P=0.002）是LDH值的影響因素。 2.治療后CK和LDH值統(tǒng)計分析：研究組CK值與對照組CK值之間差異具有統(tǒng)計學(xué)意義（p=0.000）。研究組和對照組LDH值差異不具有統(tǒng)計學(xué)意義（P＞0.05）。CK和LDH與陽性和陰性癥狀不具有相關(guān)性（P＞0.05）。 3.治療前后CK和LDH值比較：研究組自身對照CK值存在顯著差異（p=0.000）。治療前后LDH值差異不具有統(tǒng)計學(xué)意義（P＞0.05）。陽性量表總分的變化值（r=0.206，p＜0.05）與CK的變化值正相關(guān)。思維貧乏變化值（r=-0.203，p＜0.05）與CK的變化值負(fù)相關(guān)。妄想癥狀的變化（r=0.205，p＜0.05）與LDH變化值正相關(guān)，，陰性量表差值（r=-0.199，p＜0.05）與LDH的變化值負(fù)相關(guān)。 結(jié)論：精神分裂癥患者入院初期CK升高是激越攻擊行為、精神分裂癥癥狀的綜合作用，長期服用抗精神病藥物也影響CK水平。其中，軀體活動增加是精神分裂癥患者和健康人群CK升高共同的影響因素。CK水平與精神分裂癥癥狀具有相關(guān)性，CK可以作為衡量病情狀態(tài)的指標(biāo)，具有科研價值。激越攻擊行為和精神分裂癥癥狀也是LDH的影響因素，但LDH在整個病程中并無明顯變化，LDH對于外界的影響因素不敏感，不能作為衡量疾病狀態(tài)的指標(biāo)。
[Abstract]:Aim: to analyze the changes of serum creatine kinase and lactate dehydrogenase in patients with schizophrenia. Methods: 99 schizophrenic patients (study group) and 101 healthy people (control group) were selected as the study subjects. The 2ml of the middle elbow vein blood collected from 6: 00-6: 30 elbow on the second day of admission and the 4th weekend in the study group were analyzed for myocardial enzymes. The blood of the median elbow vein was collected once in the control group. The positive symptom scale (SAPSS) and the negative symptom scale (SANSS) were used to assess the disease status and aggressive behavior at 8: 00-11: 00 at the second day of admission and at the 4th weekend of the study group, respectively. Spearman rank correlation analysis was used to test the correlation between CK and LDH before and after treatment, and nonparametric test was used to compare CK and LDH differences among groups with different levels of attack risk, and the relationship between sex and attack risk was also analyzed. Multiple linear stepwise regression analysis was used to analyze the influencing factors of CK and LDH before treatment. Spearman rank correlation analysis was used to test the correlation between CK and LDH before and after treatment. The result is 1: 1. Statistical analysis of CK and LDH before treatment: there was no significant difference in CK and LDH between positive symptom group, mixed symptom group and negative symptom group (P > 0.05). The difference of CK value between the study group and the control group was statistically significant. There was no significant difference in LDH between the study group and the control group (P > 0.05). The total score of positive scale was 0.410 (p < 0.001), the total score of delusion was 0.275 (P < 0.05), and the total score of positive form of thinking was 0.288 (p < 0.05), which was positively correlated with the value of CK in the study group. Poor thinking r-0.207 (p < 0.05) was negatively correlated with CK. The total score of positive scale was 0.351 (p < 0.001) and the comprehensive evaluation of delusion was 0.207 (p < 0.05), which was positively correlated with LDH in the study group. There was a negative correlation between the LDH value and the affective bland (r)-0.248 (p < 0. 05). Attack behavior affects CK and LDH values. Multivariate stepwise regression analysis showed that aggressive behavior (尾 -0.548P + 0.000) had the greatest effect on CK, followed by age (尾 -0.282). The age of normal population was not the influence factor of CK value. Multivariate stepwise regression analysis showed that aggressive behavior (尾 -0.302) was the influencing factor of LDH. 2. Statistical analysis of CK and LDH value after treatment: the difference between CK value in study group and CK value in control group was statistically significant. The difference of LDH between the study group and the control group was not statistically significant (P > 0.05). There was no correlation between the LDH value and the positive and negative symptoms (P > 0.05). 3. Comparison of CK and LDH values before and after treatment: there were significant differences in CK values between study group and self control group (P < 0. 000). The difference of LDH before and after treatment was not statistically significant (P > 0.05). There was a positive correlation between the change of total score of positive scale and CK (P < 0.05). There was a negative correlation between the value of poor thinking and CK (r = -0.203, p < 0.05). The change of delusion symptom (P < 0.05) was positively correlated with the change value of LDH, and the difference of negative scale (r-0.199p < 0.05) was negatively correlated with the change value of LDH. Conclusion: the elevation of CK in patients with schizophrenia at the early stage of admission is an aggressive behavior. The symptoms of schizophrenia play a comprehensive role. Long-term use of antipsychotics also affects the level of CK. Among them, the increase of physical activity is the common influence factor of CK elevation in schizophrenic patients and healthy people. The level of CK is correlated with the symptoms of schizophrenia. CK can be used as an index to measure the state of the disease and has scientific research value. Agitated aggression and schizophrenia were also the influencing factors of LDH. However, there was no obvious change in LDH during the whole course of disease. LDH was insensitive to the external factors and could not be used as an index to measure the state of the disease.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.3

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