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

【摘要】：【目的】探索阿爾茨海默病(Alzheimer’s Disease,AD)、遺忘型輕度認知障礙(amnestic Mild Cognitive Impairment,a MCI)血漿s CD40、s CD40L、TNF-α濃度的特點;探索AD、a MCI血漿s CD40、s CD40L、TNF-α濃度與認知功能相關(guān)性�！痉椒ā勘狙芯恳訟D(25例)、a MCI(40例)和健康對照者(42例)為研究對象。應(yīng)用簡易精神狀態(tài)評定量表(MMSE)、聽覺詞語學習測驗(AVLT)、Boston命名測驗、數(shù)字廣度測驗(DST)、畫鐘測驗(CDT)、阿爾茨海默病評定量表-認知部分(ADAS-cog)、總體衰退量表(GDS)、臨床癡呆評定量表(CDR)、日常生活能力量表(ADL)、神經(jīng)精神癥狀評定量表(NPI)、哈金斯基缺血指數(shù)量表(HIS)評定患者認知功能及精神行為癥狀。采用商品化的ELISA試劑盒(e Bioscience)檢測血漿s CD40、s CD40L、TNF-α濃度。【結(jié)果】1、血漿s CD40濃度在AD組、a MCI組及健康對照組三組之間差異均無統(tǒng)計學意義(P0.05);血漿s CD40L濃度a MCI組均顯著高于AD組、健康對照組(均P0.05),AD組與健康對照組之間差異無統(tǒng)計學意義(P0.05);血漿TNF-α濃度a MCI組顯著高于AD組(P0.05),a MCI組和健康對照組之間差異無統(tǒng)計學意義(P0.05),AD組和健康對照組之間差異無統(tǒng)計學意義(P0.05)。2、畫鐘測驗(CDT)得分AD組均顯著低于a MCI組和NC組(均P0.001);a MCI組和NC組差異無統(tǒng)計學意義(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組間差異無統(tǒng)計學意義(P0.05)。Boston命名測驗、數(shù)字廣度測驗倒背和順背得分a MCI組和NC組差異均無統(tǒng)計學意義(均P0.05)。3、對AD組血漿s CD40、s CD40L、TNF-ɑ濃度與MMSE、ADAS-cog、NPI、DST順背、DST倒背得分進行相關(guān)性分析顯示:均無相關(guān)性(均P0.05)。對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命名測驗得分進行相關(guān)性分析顯示:s CD40L濃度與MMSE得分有顯著負相關(guān)(P=0.006)�！窘Y(jié)論】1、s CD40L可能參與了a MCI的發(fā)病過程,s CD40L、TNF-ɑ可能參與了AD免疫功能減弱的過程。2、注意、語言、執(zhí)行功能等認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患者認知損害嚴重程度的狀態(tài)指標。s CD40、s CD40L、TNF-ɑ可能不適合作為作為反映AD患者癡呆嚴重程度的狀態(tài)指標。
[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.
【學位授予單位】：中山大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R749.16

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