本文選題：阿爾茨海默病 + 胰島素�。� 參考：《山東大學(xué)》2012年碩士論文

【摘要】：背景 阿爾茨海默病(Alzheimer's disease,AD)是發(fā)生于老年期和老年前期,以進行性認知功能下降和行為損害為特征的中樞神經(jīng)系統(tǒng)退行性病變,是老年期癡呆的最常見類型。自1907年德國神經(jīng)病理學(xué)家阿爾茨海默首次報告以來,該疾病的特征越來越被人們所認識。近年來隨著我國人口老齡化的加重,阿爾茨海默病的發(fā)病率及患病率也逐漸增高。但阿爾茨海默病的發(fā)病機制尚不完全明確,代謝障礙可能是引起阿爾茨海默病的病因之一。糖代謝異常導(dǎo)致AD的潛在機制可能與高血糖的直接毒性,低血糖導(dǎo)致大腦能量供應(yīng)不足,胰島素抵抗及胰島素信號轉(zhuǎn)導(dǎo)異常,胰島素降解酶(insulin-degrading enzyme,IDE)基因異常等有關(guān)。脂源性因子瘦素(leptin,LP)是1994年發(fā)現(xiàn)的由脂肪組織分泌的激素,與糖代謝障礙、肥胖等密切相關(guān)。近年來發(fā)現(xiàn)瘦素對阿爾茨海默病的發(fā)生起保護作用,瘦素水平下降可能參與阿爾茨海默病的發(fā)病過程,。因此,研究代謝相關(guān)因子胰島素、胰島素降解酶及瘦素與AD的關(guān)系,有助于了解AD的發(fā)病機制,為治療和預(yù)防阿爾茨海默病提供新的思路和方法。 第一部分 阿爾茨海默病患者血糖、胰島素及胰島素降解酶水平的研究 目的： 探討阿爾茨海默病與血糖、胰島素及胰島素降解酶的關(guān)系,為進一步防治阿爾茨海默病提供理論依據(jù)。 方法： 選擇32例阿爾茨海默病患者(實驗組)和30例正常老年人(對照組),進行簡明精神狀態(tài)量表(MMSE)及臨床癡呆評定量表(CDR)評分,按照CDR得分再將實驗組分為輕、中、重度組。同時測量兩組的身高、體重、空腹血糖、血脂等,采用酶聯(lián)免疫吸附法和化學(xué)發(fā)光法分別檢測其血清胰島素降解酶(IDE)和胰島素水平并計算胰島素抵抗指數(shù)及體質(zhì)量指數(shù),對上述因子進行統(tǒng)計學(xué)分析,尋找各因子之間的相互關(guān)系。 結(jié)果： 1、獨立樣本t檢驗結(jié)果顯示實驗組與對照組在身高、體重、BMI、空腹血糖、總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、胰島素及胰島素抵抗指數(shù)方面無顯著差異(P0.05)。 2、獨立樣本t檢驗結(jié)果顯示與對照組相比,實驗組血清IDE水平下降(P0.05)。 3、Spearman直線相關(guān)分析顯示對照組中IDE水平與胰島素、胰島素抵抗指數(shù)之間有相關(guān)性,而在實驗組中無相關(guān)性。 4、Spearman直線相關(guān)分析顯示在實驗組中,空腹血糖水平與認知功能呈負相關(guān)(P0.05)。 5、單因素方差分析顯示輕、中、重度組患者之間血清IDE水平無明顯統(tǒng)計學(xué)差異(P0.05)。 結(jié)論： 胰島素降解酶水平的下降,與阿爾茨海默病的發(fā)生有一定相關(guān)性,在阿爾茨海默病患者體內(nèi)胰島素降解酶對胰島素及胰島素抵抗的調(diào)節(jié)可能出現(xiàn)障礙。 第二部分 阿爾茨海默病患者瘦素水平及與糖代謝關(guān)系的臨床研究 目的： 探討阿爾茨海默病患者瘦素水平的變化及瘦素與血糖、胰島素、胰島素抵抗之間的關(guān)系,為進一步防治阿爾茨海默病提供理論依據(jù)。 方法： 選擇32例阿爾茨海默病患者(實驗組)和30例正常老年人(對照組),進行MMSE及CDR評分,實驗組按照CDR得分再分為輕、中、重度組。兩組同時測量身高、體重、空腹血糖、血脂等,采用酶聯(lián)免疫吸附法和化學(xué)發(fā)光法分別檢測其血清瘦素和胰島素水平并計算胰島素抵抗指數(shù)及體質(zhì)量指數(shù),分析瘦素、胰島素及胰島素抵抗指數(shù)之間的關(guān)系,尋找在阿爾茨海默病中瘦素水平及其與胰島素之間的關(guān)系的變化。 結(jié)果： 1、獨立樣本t檢驗結(jié)果顯示實驗組與對照組在胰島素及胰島素抵抗指數(shù)水平無顯著差異(P0.05)。 2、獨立樣本t檢驗結(jié)果顯示與對照組相比,血清瘦素水平明顯下降(P0.05)。 3、Spearman直線相關(guān)分析結(jié)果顯示在對照組中瘦素水平與胰島素、胰島素抵抗指數(shù)之間有相關(guān)性,而在病例組中無相關(guān)性。 4、單因素方差分析顯示不同嚴重程度的阿爾茨海默病患者之間血清瘦素水平無統(tǒng)計學(xué)差異(P0.05)。 結(jié)論： 瘦素水平的下降,與阿爾茨海默病的發(fā)生有一定相關(guān)性,瘦素可能是AD的保護性因子；在阿爾茨海默病患者體內(nèi)瘦素與胰島素及胰島素抵抗之間的調(diào)節(jié)作用可能出現(xiàn)障礙。
[Abstract]:Background

Alzheimer ' s disease ( AD ) is the most common type of Alzheimer ' s disease . Therefore , it is helpful to understand the relationship between metabolism - related factors such as insulin , insulin - degrading enzyme and leptin and AD , which can help to understand the pathogenesis of AD and provide new ideas and methods for the treatment and prevention of Alzheimer ' s disease .

the first portion

Study on the levels of blood glucose , insulin and insulin - degrading enzymes in patients with Alzheimer ' s disease

Purpose :

To explore the relationship between Alzheimer ' s disease and blood sugar , insulin and insulin - degrading enzymes and provide theoretical basis for further prevention and treatment of Alzheimer ' s disease .

Method :

The levels of serum insulin - degrading enzyme ( IDE ) and insulin were measured by enzyme - linked immunosorbent assay ( ELISA ) and chemiluminescence method .

Results :

1 . The t - test results of independent samples showed no significant difference in height , body weight , BMI , fasting plasma glucose , total cholesterol , triglyceride , high density lipoprotein , low density lipoprotein , insulin and insulin resistance index ( P0.05 ) .

2 . The t - test results of independent samples showed that the level of serum IDE in experimental group decreased ( P0.05 ) .

The results showed that the level of IDE in the control group was correlated with insulin and insulin resistance index , but there was no correlation in the experimental group .

The results showed that fasting plasma glucose level was negatively correlated with cognitive function in the experimental group ( P0.05 ) .

5 . Single - factor analysis showed that there was no significant difference in serum IDE level between patients with mild , moderate and severe group ( P0.05 ) .

Conclusion :

The decline of insulin - degrading enzyme level is related to the occurrence of Alzheimer ' s disease , and the regulation of insulin - degrading enzyme to insulin and insulin resistance in patients with Alzheimer ' s disease may be impaired .

the second part

A clinical study on the relationship between leptin level and glucose metabolism in patients with Alzheimer ' s disease

Purpose :

To explore the relationship between leptin and insulin resistance in patients with Alzheimer ' s disease and to provide a theoretical basis for further prevention and treatment of Alzheimer ' s disease .

Method :

The levels of leptin , insulin and insulin resistance were measured by enzyme - linked immunosorbent assay and chemiluminescence method , and the relationship between leptin , insulin and insulin resistance index was analyzed . The relationship between leptin , insulin and insulin resistance index was analyzed . The relationship between leptin level and insulin resistance was found in Alzheimer ' s disease .

Results :

1 . The t - test results showed no significant difference between the experimental group and the control group at the insulin and insulin resistance index ( P0.05 ) .

2 . The t - test results of independent samples showed that the serum leptin level decreased significantly compared with the control group ( P0.05 ) .

The results showed that leptin was correlated with insulin and insulin resistance index in the control group , but there was no correlation in case group .

4 . Single - factor analysis showed that there was no significant difference in serum leptin levels between patients with Alzheimer ' s disease ( P0.05 ) .

Conclusion :

The decrease of leptin level is related to the occurrence of Alzheimer ' s disease , and leptin may be a protective factor of AD ;
The regulatory effects between leptin and insulin and insulin resistance in patients with Alzheimer ' s disease may be impaired .
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.16

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本文編號：1964339