本文選題：慢性精神分裂癥合并糖尿病 + 炎性因子��； 參考：《青島大學》2017年碩士論文

【摘要】：目的探究慢性精神分裂癥合并糖尿病(Chronic schizophrenia with diabetes mellitus,CSDM)的炎性因子(IL-6、TNF-α、IL-1β)水平與認知功能障礙之間的相關性,以期為臨床治療提供理論指導。方法本研究采取回顧性研究的方式,選取2014年12月~2016年12月在本院收治的60例CSDM患者作為觀察組,其中37例為男性患者,23例為女性患者,年齡范圍19歲~53歲,平均年齡(38.37±9.77)歲,根據認知測評結果的不同將觀察組患者分為觀察組A與觀察組B,其中觀察組A為39例輕度認知障礙患者,觀察組B為21例重度認知障礙患者。納入標準:(1)所有研究對象年齡范圍18歲~55歲;(2)所有觀察組患者均符合ICD-10精神分裂癥診斷標準;(3)所有觀察組入選患者均為CSDM患者;(4)患者均為2型糖尿病患者,FBG≥6.1mmol/L或2h PBG≥7.8mmol/L;(5)患者及其家屬均知情同意并簽署知情同意書,并經本院倫理委員會批準。排除標準:(1)患有全身性疾病;(2)患者存在心肝腎等主要臟器病變;(3)患者有家族精神病史或精神病史;(4)患者為哺乳期或處于特殊生理時期婦女;(5)患者有過敏史或曾經接受過免疫抑制劑治療。另選同期在本院進行入院體檢的精神狀況正常的志愿者40例(即無精神病史且也無家族精神病史)作為對照組,其中男性27例,女性13例,年齡18歲~54歲,平均年齡(38.64±9.96)歲。記錄并觀察兩組患者炎性因子(IL-6、TNF-α、IL-1β)水平與認知功能障礙的相關性。結果治療前觀察組患者體內IL-6、TNF-α、IL-1β水平顯著高于對照組,具有統(tǒng)計學差異(P0.05),與治療前相比較,治療后觀察組IL-6、TNF-α、IL-1β水平有所下降,但下降并不顯著,不具有統(tǒng)計學差異(P0.05);觀察組的符號編碼、言語流暢、持續(xù)操作、數字序列、言語記憶、視覺記憶、迷宮、情緒管理以及總成績與對照組相比較均明顯較低,均具有統(tǒng)計學差異(均P0.05);認知障礙組炎性分子水平顯著高于對照組,觀察組B認知障礙程度比觀察組A明顯加深,IL-6、TNF-α、IL-1β水平逐漸上升,均具有統(tǒng)計學差異(均P0.05);認知功能障礙與各炎性因子IL-6、TNF-α、IL-1β呈明顯正相關(r1=0.738,P0.05;r2=0.317,P0.05;r3=0.106,P0.05);Logistic回歸分析結果表明IL-6、TNF-α、IL-1β水平均是認知功能障礙的獨立危險因素。結論通過研究表明CSDM患者認知功能障礙與各炎性因子IL-6、TNF-α、IL-1β均呈明顯正相關;且Logistic回歸分析結果表明IL-6、TNF-α、IL-1β水平均是認知功能障礙的獨立危險因素,因此對CSDM患者體內炎性因子(IL-6、TNF-α、IL-1β)水平進行檢測,有助于對患者病情進行監(jiān)控以及治療方案的制定。
[Abstract]:Objective to explore the correlation between the levels of inflammatory factors (IL-6, TNF- a, IL-1 beta) and cognitive dysfunction in chronic schizophrenia with Chronic schizophrenia with diabetes mellitus (CSDM), and to provide theoretical guidance for clinical treatment. Methods this study was taken back to the mode of study in December 2014 and selected in December of ~2016 year of December 2014. In our hospital, 60 cases of CSDM were treated as the observation group, of which 37 were male and 23 were female, and the age range was 19 years old. The average age was (38.37 + 9.77) years old. The observation group was divided into the observation group A and the observation group B according to the difference of cognitive evaluation. Among them, the observation group was 39 cases of mild cognitive impairment, and the observation group B was 21 cases. Patients with severe cognitive impairment were included: (1) all the subjects were aged 18 years of age ~55 years; (2) all the observation groups were in accordance with the diagnostic criteria for ICD-10 schizophrenia; (3) all the observation groups were CSDM patients; (4) all patients were type 2 diabetes patients, FBG > 6.1mmol/L or 2H PBG > 7.8mmol/L; (5) patients and their families were informed. Consent and signature of informed consent, and approved by the ethics committee of the hospital. Exclusion criteria: (1) suffering from systemic disease; (2) the patients have heart and kidney and other major organ diseases; (3) the patient has a family history of mental illness or psychiatric history; (4) the patient is lactation or special physiological period women; (5) patients have an allergy history or have received immune suppression. 40 volunteers with normal mental condition in the hospital (without the history of mental illness and no family psychiatric history) were selected as the control group, including 27 men, 13 women, ~54 years of age 18, and the average age of (38.64 + 9.96) years old. The levels of inflammatory factors (IL-6, TNF- a, IL-1 beta) were recorded and observed in two groups of patients. Results the level of IL-6, TNF- a, IL-1 beta in the observation group was significantly higher than that of the control group before treatment (P0.05). Compared with the pre treatment group, the level of IL-6, TNF- A and IL-1 beta in the observation group decreased, but the decrease was not significant (P0.05), and the symbol encoding of the observation group was not significant (P0.05). Speech fluency, continuous operation, digital sequence, speech memory, visual memory, maze, mood management and total scores were significantly lower than those of the control group (all P0.05), and the level of inflammatory molecules in the cognitive impairment group was significantly higher than that of the control group. The degree of B cognitive impairment in the observation group was significantly higher than that of the observation group A, IL-6, TNF- a, IL-1 beta. There were statistical differences (all P0.05); cognitive dysfunction was positively correlated with inflammatory factors IL-6, TNF- a, IL-1 beta (r1=0.738, P0.05; r2=0.317, P0.05; r3=0.106, P0.05). Logistic regression analysis showed that IL-6, alpha, and beta were independent risk factors for cognitive dysfunction. The cognitive dysfunction of CSDM patients was positively correlated with the inflammatory factors IL-6, TNF- alpha and IL-1 beta, and the Logistic regression analysis showed that IL-6, TNF- A and IL-1 beta were independent risk factors for cognitive dysfunction. Therefore, the detection of the levels of inflammatory factors (IL-6, TNF- alpha, IL-1 beta) in patients with CSDM was helpful to the patient's condition. Monitoring and treatment plan formulation.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R749.3;R587.1

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