本文選題：阿爾茨海默病 + 遺忘型輕度認(rèn)知障礙�。� 參考：《中山大學(xué)》2015年碩士論文

【摘要】：【目的】探索阿爾茨海默病(Alzheimer’s Disease,AD)、遺忘型輕度認(rèn)知障礙(amnestic Mild Cognitive Impairment,a MCI)血漿s CD40、s CD40L、TNF-α濃度的特點(diǎn);探索AD、a MCI血漿s CD40、s CD40L、TNF-α濃度與認(rèn)知功能相關(guān)性。【方法】本研究以AD(25例)、a MCI(40例)和健康對(duì)照者(42例)為研究對(duì)象。應(yīng)用簡(jiǎn)易精神狀態(tài)評(píng)定量表(MMSE)、聽(tīng)覺(jué)詞語(yǔ)學(xué)習(xí)測(cè)驗(yàn)(AVLT)、Boston命名測(cè)驗(yàn)、數(shù)字廣度測(cè)驗(yàn)(DST)、畫(huà)鐘測(cè)驗(yàn)(CDT)、阿爾茨海默病評(píng)定量表-認(rèn)知部分(ADAS-cog)、總體衰退量表(GDS)、臨床癡呆評(píng)定量表(CDR)、日常生活能力量表(ADL)、神經(jīng)精神癥狀評(píng)定量表(NPI)、哈金斯基缺血指數(shù)量表(HIS)評(píng)定患者認(rèn)知功能及精神行為癥狀。采用商品化的ELISA試劑盒(e Bioscience)檢測(cè)血漿s CD40、s CD40L、TNF-α濃度�！窘Y(jié)果】1、血漿s CD40濃度在AD組、a MCI組及健康對(duì)照組三組之間差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);血漿s CD40L濃度a MCI組均顯著高于AD組、健康對(duì)照組(均P0.05),AD組與健康對(duì)照組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);血漿TNF-α濃度a MCI組顯著高于AD組(P0.05),a MCI組和健康對(duì)照組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),AD組和健康對(duì)照組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2、畫(huà)鐘測(cè)驗(yàn)(CDT)得分AD組均顯著低于a MCI組和NC組(均P0.001);a MCI組和NC組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。ADAS-cog總得分、ADAS-cog-記憶因子分AD組顯均著高于a MCI組、NC組(均P0.001),a MCI組顯著高于NC組(P0.001)。ADAS-cog-語(yǔ)言因子分、ADAS-cog-注意力因子分、ADAS-cog-操作能力因子分、神經(jīng)精神問(wèn)卷(NPI)得分AD組均顯著高于a MCI組、NC組(均P0.001),a MCI組和NC組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。Boston命名測(cè)驗(yàn)、數(shù)字廣度測(cè)驗(yàn)倒背和順背得分a MCI組和NC組差異均無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。3、對(duì)AD組血漿s CD40、s CD40L、TNF-ɑ濃度與MMSE、ADAS-cog、NPI、DST順背、DST倒背得分進(jìn)行相關(guān)性分析顯示:均無(wú)相關(guān)性(均P0.05)。對(duì)a MCI組血漿s CD40、s CD40L、TNF-ɑ濃度與MMSE、ADAS-cog、NPI、DST順背、DST倒背、Boston命名測(cè)驗(yàn)得分進(jìn)行相關(guān)性分析顯示:s CD40L濃度與MMSE得分有顯著負(fù)相關(guān)(P=0.006)�！窘Y(jié)論】1、s CD40L可能參與了a MCI的發(fā)病過(guò)程,s CD40L、TNF-ɑ可能參與了AD免疫功能減弱的過(guò)程。2、注意、語(yǔ)言、執(zhí)行功能等認(rèn)知功能損害較記憶障礙出現(xiàn)晚,均在AD階段出現(xiàn)。3、s CD40L可能可以作為反映aMCI患者認(rèn)知損害嚴(yán)重程度的狀態(tài)指標(biāo)。s CD40、s CD40L、TNF-ɑ可能不適合作為作為反映AD患者癡呆嚴(yán)重程度的狀態(tài)指標(biāo)。
[Abstract]:[objective] to explore the characteristics of plasma s CD40 and CD40 LT TNF- 偽 levels in patients with Alzheimer's disease (AD) and amnestic cognitive impairment (MCI). To explore the correlation between the plasma levels of sCD40L- 偽 and cognitive function in patients with adriamycin A MCI. [methods] A total of 40 patients with AD (25 cases) and 42 healthy controls (n = 42) were studied in this study. Simple mental state assessment scale (MMSE), auditory word learning test (AVLT) and Boston nomenclature test were used. Digital Span Test (DST), clock drawing Test (CDT), Alzheimer's Disease rating scale-Cognitive part (ADAS-cog), General decline scale (GDS), Clinical dementia rating scale (CDR), ability of Daily living (ADL), Neuropsychiatric symptom scale (NPI), Hazinsky Ischemia The index scale (his) was used to assess the cognitive function and mental behavior of the patients. Using commercial Elisa kit (e Bioscience) to detect the concentration of plasma s CD40 / L TNF- 偽. [results] 1. There was no significant difference in plasma s CD40 concentration between AD group and healthy control group (P0.05), and the plasma s CD40L concentration in aMCI group was significantly higher than that in AD group. There was no significant difference between AD group and healthy control group (P0.05), and the plasma TNF- 偽 concentration in a MCI group was significantly higher than that in AD group (P0.05) and healthy control group (P0.05). (P0.05) there was no significant difference between AD group and healthy control group (P0.05). The score of clock drawing test (CDT) in AD group was significantly lower than that in AMCI group and NC group (P0.001). There was no significant difference between AD group and NC group (P0.05). ADAS-cog- memory factor score in AD group was significantly higher than that in NC group (P0.001). The scores of ADAS-cog-language factor and ADAS-cog-attention factor were significantly higher than those of NC group (P0.001). The scores of neuropsychiatric questionnaire (NPI) in AD group were significantly higher than those in NC group (P0.001), and there was no significant difference between AD group and NC group (P0.05) .Boston nomenclature test. There was no significant difference between the two groups (P0.05). The correlation analysis between the plasma sCD40L ~ + TNF- and the MMSE ADAS-CogN NPII-DST reverse back score showed that there was no correlation between the plasma sCD40L- CD40L- TNF- and MMSEN-ADAS-CogCG-NPII-DST inverse DST scores in AD group (all P 0.05). The results showed that there was no significant difference between the two groups in the scores of reverse back and forward back (P < 0.05). The correlation analysis between the plasma sCD40, sCD40L, TNF-, and the MMSE ADAS-CogGN NPIST DST reverse DST Boston nomenclature test showed that there was a significant negative correlation between the concentration of 10% s CD40L and the MMSE score (P0. 006). [conclusion] 1s CD40L may be involved in the pathogenesis of a MCI, and the CD40L may be involved in the pathogenesis of aMCI. Can participate in AD immune function decline. 2, pay attention, Cognitive impairment such as language and executive function appears later than memory impairment. The occurrence of. 3s CD40L in AD may be a state index to reflect the severity of cognitive impairment in patients with aMCI. S CD40 / TNF- may not be suitable as a state index to reflect the severity of dementia in AD patients.
【學(xué)位授予單位】：中山大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R749.16

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