發(fā)布時間：2018-08-29 12:17

【摘要】：目的:輕度認知功能障礙是一種介于正常衰老與癡呆之間的不穩(wěn)定過渡狀態(tài),處在這個階段的患者存在高于其年齡階段允許的認知功能障礙,患者日常生活能力不受影響,存在認知功能障礙且達不到癡呆的診斷標(biāo)準(zhǔn),其在極短時間內(nèi)便可能發(fā)展為癡呆。且所有治療癡呆的藥物均會對人體造成損害。故在輕度認知功能障礙階段,積極控制危險因素,早發(fā)現(xiàn),早干預(yù),對于提高輕度認知功能障礙患者的生活質(zhì)量具有重要意義。本研究用人類血漿脂蛋白相關(guān)磷脂酶A2(Lp-PLA2)對輕度認知功能障礙進行風(fēng)險評估;探討影響輕度認知功能障礙的危險因素;研究LP-PLA2水平與輕度認知功能障礙之間的關(guān)系。方法:回顧性分析2016年5月—2016年12月在陜西省人民醫(yī)院住院治療的輕度認知功能障礙患者100例(研究組),以及同時期的健康體檢者100例(對照組)。對所有入選的輕度認知功能障礙患者和健康體檢者進行MoCA評分,分別對比Lp-PLA2的活性。所有入選對象入院后3天內(nèi)采用蒙特利爾認知評估量表(MoCA)檢查患者的認知功能,并對MoCA評分進行統(tǒng)計;探測輕度認知功能障礙組患者和健康體檢者的Lp-PLA2水平;統(tǒng)計所有入選對象的年齡、性別、腦卒中史、文化程度、吸煙史、飲酒史、高血壓、糖尿病、冠心病、甘油三酯(TG)、膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C),分析各指標(biāo)對MoCA評分的影響;分析輕度認知功能障礙組患者Lp-PLA2水平與MoCA評分的相關(guān)性。數(shù)據(jù)經(jīng)過處理后,采用SPSS 22.0統(tǒng)計軟件進行分析,P0.05有統(tǒng)計學(xué)意義。結(jié)果:1.研究組Lp-PLA2水平與MoCA評分呈負相關(guān)性(r=-0.62,P0.05)。2.兩組相比,輕度認知功能障礙組患者的Lp-PLA2水平明顯高于健康對照組患者,差異具有統(tǒng)計學(xué)意義(P0.05),且Lp-PLA2水平越高,MoCA評分越低。3.輕度認知功能障礙組患者中,男性為64%,女性占到36%,且男性患者的LpPLA2水平明顯高于女性患者,差異具有統(tǒng)計學(xué)意義(P0.05);男性患者MoCA評分明顯低于女性患者,差異具有統(tǒng)計學(xué)意義(P0.05)。4.研究組中受教育年限12年的患者Lp-PLA2水平低于≤12年的患者,但差異無統(tǒng)計學(xué)意義(P0.05);12年的患者Mo CA評分明顯高于≤12年的患者,差異具有統(tǒng)計學(xué)意義(P0.05)。5.飲酒史、腦卒中史、糖尿病史對輕度認知功能障礙有影響,吸煙史、高血壓史、冠心病史、LDL、HDL、TG、TC對輕度認知功能障礙無影響。6.HDL與MoCA評分之間有正相關(guān)性(r=0.165,P=0.02),年齡、Lp-PLA2與MoCA評分之間有負相關(guān)性(r=-0.403,P=0.00;r=-0.413,P=0.00);而LDL、TG、TC與MoCA評分無相關(guān)性。7.Lp-PLA2是輕度認知功能障礙發(fā)生的獨立影響因素。結(jié)論:1.Lp-PLA2與輕度認知功能障礙具有相關(guān)性,Lp-PLA2水平越高,輕度認知功能障礙越嚴重。2.輕度認知功能障礙患者中男性的發(fā)病率要高于女性。3.輕度認知功能障礙患者中受教育年限12年的MoCA評分要明顯高于≤12年的患者。4.HDL與MoCA評分之間有正相關(guān)性,年齡、Lp-PLA2與MoCA評分之間有負相關(guān)性。5.Lp-PLA2是輕度認知功能障礙發(fā)生的獨立影響因素。
[Abstract]:Objective: Mild cognitive impairment is an unstable transitional state between normal aging and dementia. At this stage, patients have cognitive impairment which is higher than their age, their daily living ability is unaffected, their cognitive impairment is not up to the diagnostic standard of dementia, and they have stool in a very short time. It may develop dementia, and all drugs for dementia can cause damage to the human body. Therefore, it is important to actively control risk factors, early detection and early intervention in the stage of mild cognitive impairment to improve the quality of life in patients with mild cognitive impairment. Methods: A retrospective analysis of 100 patients with mild cognitive impairment hospitalized in Shaanxi Provincial People's Hospital from May 2016 to December 2016 was conducted. All patients with mild cognitive impairment and healthy subjects were assessed with MoCA and compared with the activity of Lp-PLA2. All subjects were assessed with the Montreal Cognitive Assessment Scale (MoCA) within 3 days after admission, and the scores of MoCA were detected. Levels of Lp-PLA2 in patients with mild cognitive impairment and healthy subjects were measured, and age, sex, stroke history, education level, smoking history, drinking history, hypertension, diabetes, coronary heart disease, triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were analyzed. The correlation between Lp-PLA2 level and MoCA score in patients with mild cognitive impairment was analyzed. The data were processed and analyzed by SPSS 22.0 statistical software. The results showed that: 1. There was a negative correlation between Lp-PLA2 level and MoCA score (r =-0.62, P 0.05). The level of LP-PLA2 in patients with mild cognitive impairment was 64% in males and 36% in females, and the level of LP-PLA2 in males was significantly higher than that in females (P 0.05). The MoCA score of male patients was significantly lower than that of female patients (P 0.05). 4. The Lp-PLA2 level of patients with 12 years of education was lower than that of patients with 12 years of education, but there was no significant difference (P 0.05); the MoCA score of patients with 12 years of education was significantly higher than that of patients with 12 years of education (P 0.05). Stroke history and diabetes mellitus history had an impact on mild cognitive impairment. Smoking history, hypertension history, coronary heart disease history, LDL, HDL, TG, TC had no effect on mild cognitive impairment. 6. There was a positive correlation between HDL and MoCA score (r = 0.165, P = 0.02), age, Lp-PLA2 and MoCA score were negatively correlated (r = - 0.403, P = 0.00; r = - 0.413, P = 0.00), while LDL, TG, TG, and TC were negatively correlated. Lp-PLA2 was associated with mild cognitive impairment. The higher the Lp-PLA2 level, the more severe the mild cognitive impairment. 2. The incidence of mild cognitive impairment in males was higher than that in females. 3. Mild cognitive impairment. There was a positive correlation between HDL and MoCA score. Age, Lp-PLA2 and MoCA score were negatively correlated. 5. Lp-PLA2 was an independent factor for mild cognitive impairment.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.16

【參考文獻】

相關(guān)期刊論文 前10條

1 俞春江;劉偉;李峰;楊鳴;;不同類型認知功能障礙患者的脂蛋白結(jié)合磷脂酶A2水平[J];中國腦血管病雜志;2011年05期

2 邱燕東;畢桂南;石勝良;黎彬如;;輕度認知障礙和阿爾茨海默病患者血白細胞介素-6水平變化[J];廣西醫(yī)學(xué);2010年12期

3 王桂芳;魏英玲;曲福玲;;輕度認知障礙的危險因素分析[J];中國康復(fù);2010年05期

4 張洪濤;張道培;張淑玲;付勝奇;;血管性認知障礙非癡呆患者血漿Lp-PLA2活性變化的初步探討[J];山東醫(yī)藥;2010年12期

5 高金穎;樊東升;沈揚;古雅蘭;楊志杰;;青中年輕度認知損害的危險因素分析[J];中國神經(jīng)免疫學(xué)和神經(jīng)病學(xué)雜志;2008年06期

6 關(guān)紹晨;湯哲;吳曉光;刁麗君;劉宏軍;孫菲;方向華;;北京老年人群輕度認知障礙患病情況及危險因素的抽樣調(diào)查[J];中國腦血管病雜志;2008年09期

7 易偉寧;康曉平;;中國高齡老人認知功能影響因素的多水平分析[J];中國心理衛(wèi)生雜志;2008年07期

8 湯哲;張欣卿;吳曉光;劉宏軍;刁麗君;關(guān)紹晨;孫菲;方向華;陳彪;;北京城鄉(xiāng)老年人輕度認知障礙患病率調(diào)查[J];中國心理衛(wèi)生雜志;2007年02期

9 劉彬,韶紅,彭永革,丁惠瑩;對深圳羅湖區(qū)老年人輕度認知障礙的調(diào)查與分析[J];廣州中醫(yī)藥大學(xué)學(xué)報;2005年05期

10 敖晉,柳玉芝;中國高齡老人認知下降及相關(guān)因素[J];中國心理衛(wèi)生雜志;2004年02期

相關(guān)碩士學(xué)位論文 前4條

1 楊麗慧;脂蛋白相關(guān)磷脂酶A2和海馬體積測定在認知功能障礙患者診斷中的應(yīng)用價值[D];蘇州大學(xué);2016年

2 吳倩;炎癥因子與輕度認知功能障礙的相關(guān)性及藥物干預(yù)研究[D];石河子大學(xué);2014年

3 丁莉;55歲及以上人群輕度認知功能障礙現(xiàn)狀及其影響因素[D];寧夏醫(yī)科大學(xué);2013年

4 楊禮;老年高干人群輕度認知功能障礙的調(diào)查及危險因素分析[D];廣州醫(yī)學(xué)院;2011年

，

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