本文選題：精神分裂癥 + 腦源性神經(jīng)營(yíng)養(yǎng)因子(BDNF)��； 參考：《揚(yáng)州大學(xué)》2017年碩士論文

【摘要】：目的:精神分裂癥是一種嚴(yán)重的精神疾病,有證據(jù)顯示神經(jīng)營(yíng)養(yǎng)因子異�？赡軐�(dǎo)致中樞及外周神經(jīng)系統(tǒng)神經(jīng)發(fā)育、神經(jīng)連接及神經(jīng)可塑性的異常。目前研究認(rèn)為神經(jīng)營(yíng)養(yǎng)因子可能與精神分裂癥患者的病理生理機(jī)制和認(rèn)知功能有關(guān)。腦源性神經(jīng)營(yíng)養(yǎng)因子(brain-derived neurotrophic factor,BDNF)和膠質(zhì)源性神經(jīng)營(yíng)養(yǎng)因子(glial cell line-derived neurotrophic factor,GDNF)在精神疾病的研究領(lǐng)域得到了越來(lái)越多的重視。同時(shí)隨著神經(jīng)電生理技術(shù)的進(jìn)步,事件相關(guān)電位尤其是事件相關(guān)電位P300被廣泛應(yīng)用于認(rèn)知功能領(lǐng)域的研究。因此本研究利用認(rèn)知量表及事件相關(guān)電位P300作為研究認(rèn)知功能工具,探索長(zhǎng)期住院的男性精神分裂癥患者血清神經(jīng)營(yíng)養(yǎng)因子(BDNF、GDNF)水平的變化、認(rèn)知功能的狀況以及血清BDNF、GDNF水平與認(rèn)知功能及事件相關(guān)電位P300之間的相關(guān)性。方法:2015年8月至2016年7月入組82例在江蘇省揚(yáng)州五臺(tái)山醫(yī)院長(zhǎng)期住院的男性精神分裂癥患者和52例正常對(duì)照組。采用言語(yǔ)流暢性測(cè)試(動(dòng)作命名測(cè)試、動(dòng)物命名測(cè)試)、數(shù)字劃消測(cè)試、連線(xiàn)測(cè)試(Trail Making Test,TMT,包括 TMT-A、TMT-B)、Stroop 測(cè)試(單詞、顏色、色詞干擾測(cè)試)、木塊圖測(cè)試、WMS-Ⅲ空間廣度測(cè)試(WechslerMemory Scale-Ⅲ Spatial Span Test,WMS-Ⅲ SST)評(píng)估患者與正常組的認(rèn)知功能。采用美國(guó)Nicolet Viking Quste誘發(fā)電位儀記錄事件相關(guān)電位P300的潛伏期和波幅。同時(shí)通過(guò)酶聯(lián)免疫吸附法(Enzyme Linked Immunosorbent Assay,ELISA)檢測(cè)所有被試者的血清 BDNF、GDNF濃度。結(jié)果:1.患者組與對(duì)照組血清BDNF水平分別為(9.1±2.1)ng/ml和(11.6±2.3)ng/ml,兩組間血清BDNF水平存在統(tǒng)計(jì)學(xué)差異(t=-6.186,P0.01);患者組與對(duì)照組血清GDNF水平分別為(603.4±182.6)pg/ml和(610.22±176.3)pg/ml,兩組間血清GDNF水平無(wú)統(tǒng)計(jì)學(xué)差異(t=0.201,P0.05)。2.患者組在言語(yǔ)流暢性功能(動(dòng)作命名測(cè)試、動(dòng)物命名測(cè)試)、注意功能(數(shù)字劃消測(cè)試、TMT-A、單詞測(cè)試、顏色測(cè)試)、執(zhí)行功能(色詞干擾測(cè)試、TMT-B)以及空間功能(木塊圖測(cè)試、WMS-Ⅲ SST)都顯著差于對(duì)照組,且都具有統(tǒng)計(jì)學(xué)意義(P0.01)�；颊呓M認(rèn)知量表與年齡、受教育年限、病程和PANSS評(píng)分之間具有一定的相關(guān)性。患者組事件相關(guān)電位P300潛伏期較正常組明顯延長(zhǎng)(t=22.990,P0.01),波幅較正常組明顯降低(t=-9.699,P0.01)。3.在患者組,事件相關(guān)電位P300潛伏期與數(shù)字劃消測(cè)試及TMT-A呈正相關(guān)(r=0.481,P0.01;r=0.245,P0.05),事件相關(guān)電位P300波幅與數(shù)字劃消測(cè)試呈負(fù)相關(guān)(r=-0.338,P0.01)。在患者組,血清BDNF水平與數(shù)字劃消測(cè)試、TMT-B呈負(fù)相關(guān)(r=-0.281,P0.05;r=-0.355,P0.05)。患者組的血清GDNF水平與木塊圖測(cè)試呈正相關(guān)(r=0.272,P0.05)。4.患者組血清BDNF水平與事件相關(guān)電位P300的潛伏期呈負(fù)相關(guān)與波幅呈正相關(guān)(r=-0.262,P0.05;r=0.365,P0.01)。血清GDNF水平與事件相關(guān)電位P300的潛伏期及波幅沒(méi)有相關(guān)性。結(jié)論:1.處于疾病相對(duì)穩(wěn)定期的精神分裂癥患者仍存在認(rèn)知功能的損害。2.血清BDNF水平可能是精神分裂癥患者的一種素質(zhì)性的生物標(biāo)志。3.血清BDNF、GDNF水平可能與精神分裂癥患者認(rèn)知功能之間存在一定的相關(guān)性。4.血清BDNF水平可能與精神分裂癥患者事件相關(guān)電位P300之間存在一定的相關(guān)性。
[Abstract]:Objective: schizophrenia is a serious mental illness. There is evidence that abnormal neurotrophic factors may lead to neurodevelopment, nerve connections and abnormal plasticity in the central and peripheral nervous system. Neurotrophic factors may be associated with the pathophysiological mechanism and cognitive function of schizophrenic patients. The brain-derived neurotrophic factor (BDNF) and glial derived neurotrophic factors (glial cell line-derived neurotrophic factor, GDNF) have been paid more and more attention in the field of mental illness. Meanwhile, with the progress of neurophysiological technology, the event related potential, especially the event related potential P300 This study uses the cognitive scale and the event related potential P300 as a cognitive function tool to explore the changes in serum neurotrophic factor (BDNF, GDNF) levels, the status of cognitive function and the level of serum BDNF, GDNF and cognitive function in the long hospitalized male schizophrenic patients. And the correlation between the event related potential P300. Methods: from August 2015 to 7 2016, 82 cases of male schizophrenic patients and 52 normal controls were enrolled in the Yangzhou Wu Tai Mountain Hospital of Jiangsu province for a long time. The speech fluency test (action naming test, animal naming test), digital elimination test, and connection test (Trail Making T) were used. EST, TMT, including TMT-A, TMT-B), Stroop test (word, color, color word interference test), block diagram test, WMS- III space span test (WechslerMemory Scale- III Spatial Span Test, WMS- III) evaluate the cognitive function of patients and normal groups. The serum BDNF and GDNF concentrations of all the subjects were detected by Enzyme Linked Immunosorbent Assay (ELISA). Results: the serum BDNF levels of the 1. patients and the control group were (9.1 + 2.1) ng/ml and (11.6 + 2.3) ng/ml respectively, and there were statistical differences in the BDNF level between the two groups. The level of serum GDNF in the control group was (603.4 + 182.6) pg/ml and (610.22 + 176.3) pg/ml, and there was no statistical difference between the two groups (t=0.201, P0.05) in.2. patients in the speech fluency function (the action naming test, animal naming test), the attention function (Digital elimination test, TMT-A, word test, color test), and the executive function (color word stem). The interference test, TMT-B) and the spatial function (block diagram test, WMS- III SST) were all significantly worse than the control group, and all had statistical significance (P0.01). The patient group cognitive scale had a certain correlation with age, the years of education, the course of disease and the PANSS score. The latency of the event related potential P300 in the patient group was significantly longer than that of the normal group (t=22.990, P0.0). 1), the amplitude of wave amplitude was significantly lower than that of the normal group (t=-9.699, P0.01).3. in the patient group, the latency of the event related potential P300 was positively correlated with the digital cancellation test and TMT-A (r=0.481, P0.01; r=0.245, P0.05), and the event related potential P300 amplitude was negatively correlated with the digital cancellation test (r=-0.338, P0.01). -B was negatively correlated (r=-0.281, P0.05; r=-0.355, P0.05). The serum GDNF level of the patient group was positively correlated with the test of block diagram (r=0.272, P0.05). The serum BDNF level and the incubation period of the event related potential P300 were positively correlated with the amplitude of the amplitude. There is no correlation between phase and amplitude. Conclusion: 1. the schizophrenia patients in the relatively stable period of the disease still have cognitive impairment, the level of.2. serum BDNF may be a quality-oriented biomarker of.3. serum BDNF in schizophrenic patients, and the level of GDNF may have a certain correlation with the cognitive function of the schizophrenic patients,.4. There may be a correlation between serum BDNF level and event-related potential P300 in schizophrenic patients.
【學(xué)位授予單位】：揚(yáng)州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R749.3

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