本文選題：阿爾茲海默病 + 帕金森病��； 參考：《山東理工大學》2013年碩士論文

【摘要】：維生素D是人體內(nèi)必不可少的重要的維生素之一,已有報道稱維生素D的缺乏與糖尿病、高血壓、多發(fā)性硬化和認知功能障礙等疾病的形成密切相關(guān),所以社會對于維生素D的研究越來越關(guān)注。進來,維生素D與神經(jīng)退行性疾病,特別是對阿爾茲海默病(AD)和帕金森病(PD)的研究引起了人們的注意。我們對阿爾茲海默病和帕金森病患者中維生素D濃度以及其相關(guān)因素的影響進行了研究,得到的研究成果主要有以下三個部分：(一)很多研究結(jié)果顯示了AD和PD患者中維生素D濃度與對照組中的比較關(guān)系。我們的研究目的是對現(xiàn)有的信息和資料進行總結(jié),進而得到AD和PD患者中維生素D濃度與對照組中的比較關(guān)系。首先通過對相關(guān)數(shù)據(jù)庫的資料的檢索和篩選,然后得到6篇關(guān)于AD包括319個病例和573個對照的文獻以及5篇關(guān)于PD包括434個病例和3451個對照的文獻,共10篇并將它們納入我們的meta分析中。利用相關(guān)軟件進行meta分析,得到的結(jié)果是對于AD的合并的標準化均數(shù)差SMD(95% CI)為-1.39(-2.79-0.01),對于PD的合并的標準化均數(shù)差SMD(95% CI)為-1.33(-2.44--0.21)。表明在AD和PD的病人中維生素D的含量比對照組健康人中的含量低。(二)已有證據(jù)說明維生素D的含量是骨骼正常的一個重要的因素,而且低濃度的25(OH)D可導致肌無力并增加患骨折與骨質(zhì)疏松癥的發(fā)病率。加上上面我們得到的在AD和PD的病人中25(OH)D的含量低,因此我們做了關(guān)于骨折和AD以及骨質(zhì)疏松癥和PD的meta分析。鑒于骨折與骨質(zhì)疏松癥的鑒定都與骨密度BMD有關(guān),我們進一步做了一個關(guān)于骨密度和AD以及PD的meta分析。對于AD最后納入了9篇文獻。利用比值比OR(95% CI)固定模型得到的結(jié)果是合并效應量ES(95% CI)為2.58(2.03—3.14),利用二分量得到的結(jié)果是合并OR(95%CI)為1.8(1.54—2.11)。表明AD病人更容易患骨折。進一步meta分析的結(jié)果發(fā)現(xiàn)AD病人中BMD的含量比對照組健康人中的含量低(SMD=-1.12,95% CI=-1.34--0.90)。對于PD最后納入了15篇文獻。結(jié)果表明PD病人更容易患骨質(zhì)疏松癥(OR=1.18,95% CI=1.09-1.27),而且男病人比女病人更容易患病(男OR=2.44,95%CI=1.37-4.34;女OR=1.16,95%CI=1.07—1.26)。進一步meta分析的結(jié)果發(fā)現(xiàn)PD病人中髖部、腰椎及股骨頸處BMD的含量比對照組健康人中的含量低。(三)維生素D的一些生物學功能是通過維生素D受體(VDR)介導維生素D活性分子1,25(OH)2D來發(fā)揮作用的。因此我們猜測VDR與AD和PD之間也有一定的關(guān)系,故我們做了VDR多態(tài)性和AD的meta分析。最后有4篇文獻納入了meta分析中。結(jié)果顯示AD患者中VDR多態(tài)性基因ApaI的A等位基因出現(xiàn)的頻率低(OR=0.79,95% CI=0.65-0.96), TaqI的T等位基因出現(xiàn)的頻率低(OR=0.79,95% CI=0.65-0.96),而FokI得F等位基因?qū)D的發(fā)病率沒有影響(OR=1.04,95% CI=0.89-1.23)。這些研究結(jié)果對于AD的預防和治療有一定的理論指導意義。
[Abstract]:Vitamin D is one of the most important vitamins in human body. It has been reported that vitamin D deficiency is closely related to the development of diabetes mellitus, hypertension, multiple sclerosis and cognitive impairment. So society is paying more and more attention to the study of vitamin D. Vitamin D and neurodegenerative diseases, especially Alzheimer's disease (AD) and Parkinson's disease (PD), have attracted attention. We studied the effects of vitamin D concentrations and related factors in patients with Alzheimer's disease and Parkinson's disease. The main results are as follows: (1) the results of many studies show the relationship between vitamin D concentration in AD and PD patients and control group. The aim of our study was to summarize the available information and to obtain the comparative relationship between vitamin D concentrations in AD and PD patients and controls. By searching and screening the relevant databases, we obtained 6 articles on AD, including 319 cases and 573 controls, and 5 articles on PD, including 434 cases and 3 451 controls. A total of 10 articles were included in our meta analysis. The results obtained by meta analysis are as follows: for AD, the standardized mean difference (95% CI) is -1.39 (-2.79-0.01), and for PD, the normalized mean difference (SMD) is -1.33 (-2.44-0.21). The results showed that the level of vitamin D in AD and PD patients was lower than that in healthy controls. (II) there is evidence that vitamin D levels are an important factor in normal bones and that low concentrations of 25 (OH) D can lead to myasthenia and increase the incidence of fractures and osteoporosis. Plus, we found that 25 (OH) D levels were low in AD and PD patients above, so we did meta analysis of fractures and AD and osteoporosis and PD. Since the identification of fractures and osteoporosis is related to BMD, we further performed a meta analysis of BMD and AD and PD. For AD, 9 articles were included. The results obtained by the fixed ratio OR (95% CI) model are as follows: es (95% CI) is 2.58 (2.03-3.14), and the combined OR (95% CI) is 1.8 (1.54-2.11) by using two-component. This suggests that AD patients are more likely to suffer from fractures. The results of further meta analysis showed that the content of BMD in AD patients was lower than that in healthy controls (SMD-1.1295% CI -1.34--0.90). For PD, 15 articles were included. The results showed that PD patients were more likely to suffer from osteoporosis (ORL 1.1895% CI 1.09-1.27), and male patients were more likely to suffer from osteoporosis than female patients (male OR2.495 CI 1.37-4.34; female OR1.1695CII 1.07-1.26). Further meta analysis showed that the levels of meta in the hip, lumbar and femoral neck of PD patients were lower than those in healthy controls. (3) some biological functions of vitamin D are mediated by vitamin D receptor (VDR) -mediated vitamin D active molecule 1o 25 (OH) 2D. Therefore, we speculated that there was a certain relationship between VDR and AD and PD, so we did the meta analysis of VDR polymorphism and AD. Finally, four articles were included in the meta analysis. The results showed that the frequency of A allele of VDR polymorphic gene ApaI was low (OR0.79% 95% CI 0.65-0.96), the frequency of T allele of TaqI was low (OR0.79% 95% CI 0.65-0.96), and the F allele of FokI had no effect on the incidence of AD (ORX 1.0495% CI 0.89-1.23). These results have a certain theoretical significance for the prevention and treatment of AD.
【學位授予單位】：山東理工大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R749.16;R742.5

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