【摘要】：背景：隨著世界人口的不斷老齡化,癡呆正在成為一個全球性的公共衛(wèi)生問題。阿爾茨海默病(Alzheimer's disease, AD)是一種進行性中樞神經(jīng)系統(tǒng)的退行性疾病。臨床表現(xiàn)為進行性記憶和認知障礙、言語障礙、精神運動異常等。輕度認知障礙(Mild cognitive impairment, MCI)是介于正常老化和癡呆或AD之間的臨床過渡階段,目前逐漸成為研究的熱點。以往的研究中同型半胱氨酸(Homocysteine, Hcy)水平與老年癡呆癥或MCI的相關(guān)性是有爭議的,一些研究顯示高Hcy會增加認知障礙的風險。進一步研究Hcy與AD及MCI的關(guān)系,對AD的預防及指導治療有重要意義。 目的：探討山西呂梁地區(qū)農(nóng)村AD及MCI與Hcy的關(guān)系,以及與葉酸及維生素B12的關(guān)系,為AD的預防及指導治療提供依據(jù)。 方法：通過對低葉酸地區(qū)山西呂梁農(nóng)村3個鎮(zhèn)55歲及以上6452個老年人的橫斷面調(diào)查,篩選出AD患者135例,MCI患者157例。采用病例對照研究的方法,選取資料全面及抽血的AD患者63名,MCI患者95名,按病例組的年齡、性別、地區(qū)、教育程度等互相匹配隨機選出對照組90例,用熒光偏振免疫分析法(fluorescence polarization immunassay, FPIA)測出Hcy水平,用微粒子酶免分析法(microparticle enzyme immunoassay, MELA)測定葉酸及維生素B12水平。用統(tǒng)計學軟件SPSS17.0進行統(tǒng)計分析。 結(jié)果：1.AD、MCI及對照組Hcy水平分別為26.6±19.94μmol/L、27.2±19.80μmol/L、19.7±14.42μmol/L,三組之間差異有統(tǒng)計學意義(p0.05)。AD組與對照組之間Hcy水平有統(tǒng)計學意義(p0.05),MCI組與對照組之間Hcy水平有統(tǒng)計學意義(p0.05),而AD組與MCI組之間差異無統(tǒng)計學意義(p0.05)。2.AD、MCI及對照組的葉酸值分別為10.0±10.97ng/mL、10.6±11.32ng/mL、11.4±11.81ng/mL,三組之間差異無統(tǒng)計學意義(p0.05),且組間差異均無統(tǒng)計學意義(p0.05)。AD、MCI及對照組的維生素B12值分別為157.31±91.10pg/mL、185.48±379.29pg/mL、195.2±389.25pg/mL,三組之間差異無統(tǒng)計學意義(p0.05),且組間差異均無統(tǒng)計學意義(p0.05)。 結(jié)論：1.呂梁地區(qū)農(nóng)村AD及MCI患者的Hcy水平高于對照組；2.呂梁地區(qū)農(nóng)村高Hcy水平可能為AD、MCI的危險因素；3.呂梁地區(qū)農(nóng)村AD及MCI患者的葉酸及維生素B12水平可能并未顯著低于對照組。
[Abstract]:Background: with the aging of the world population, dementia is becoming a global public health problem. Alzheimer's disease (Alzheimer's disease, AD) is a progressive degeneration of the central nervous system. The clinical manifestations were progressive memory and cognitive impairment, speech disorder, psychomotor disorder and so on. Mild cognitive impairment (Mild cognitive impairment, MCI) is a clinical transition between normal aging and dementia or AD. The association of homocysteine (Homocysteine, Hcy) levels with Alzheimer's disease or MCI has been controversial in previous studies, and some studies have shown that high Hcy increases the risk of cognitive impairment. Further study on the relationship between Hcy, AD and MCI is of great significance to the prevention and treatment of AD. Objective: to explore the relationship between AD, MCI and Hcy, folic acid and vitamin B12 in rural areas of Lv Liang, Shanxi Province, and to provide evidence for the prevention and treatment of AD. Methods: a cross-sectional survey of 6452 elderly people aged 55 years and above in 3 towns of Lv Liang in Shanxi Province in low folic acid area was carried out. One hundred and fifty-five patients with AD were selected. Using the method of case-control study, we selected 63 patients with AD with comprehensive data and 95 patients with AD. 90 cases of control group were randomly selected according to the matched age, sex, region and education level of the case group. The levels of Hcy and folic acid and vitamin B12 were measured by fluorescence polarization immunoassay (fluorescence polarization immunassay, FPIA) and microparticle enzyme immunoassay (microparticle enzyme immunoassay, MELA) respectively. Statistical software SPSS17.0 was used for statistical analysis. Results: 1. The Hcy levels of ADMCI and control group were 26.6 鹵19.94 渭 mol/L,27.2 鹵19.80 渭 mol/L,19.7 鹵14.42 渭 mol/L, respectively. There were significant differences in Hcy level between AD group and control group (p0.05). Hcy level between AD group and MCI group was statistically significant (p0.05). There was no significant difference between the three groups (p0.05). 2. The folic acid values of the control group and the control group were 10.0 鹵10.97ng / mLnL = 10.6 鹵11.32ng / mL, 11.4 鹵11.81ng / mL, respectively. There was no significant difference among the three groups (p0.05), and there was no significant difference between the three groups (p0.05). The values of vitamin B12 in the control group and the control group were 157.31 鹵91.10pg / mLnL 185.48 鹵379.29pgmL195.2 鹵389.25pgmLrespectively, and there was no statistical difference between the three groups. There was no significant difference between the two groups (p 0.05). Conclusion 1. The level of Hcy in rural AD and MCI patients in Lv Liang area was higher than that in control group. High Hcy level may be the risk factor of AD,MCI in Lv Liang area. The levels of folic acid and vitamin B 12 in rural AD and MCI patients in Lv Liang area may not be significantly lower than those in control group.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R749.16

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