發(fā)布時間：2017-12-31 11:05

  本文關(guān)鍵詞：運動行為對老年T2DM患者血清BDNF，，甲基乙二醛及認(rèn)知功能的影響　出處：《蘭州大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 老年2型糖尿病 認(rèn)知功能 甲基乙二醛 腦源性神經(jīng)營養(yǎng)因子 糖尿病 2型 老年 運動行為 認(rèn)知功能 MG BDNF

【摘要】：目的:探討老年T2DM患者的血清BDNF,MG水平,認(rèn)知功能及三者之間的相互影響。方法:本研究采取頻數(shù)匹配方法選取病例及正常人群進行對照。本研究選取蘭州大學(xué)第二醫(yī)院糖尿病2,3科老年2型糖尿病患者64例,均來自于2014年2月一2015年3月該時間段住院患者。對照組為相同時間段前往蘭州大學(xué)第二醫(yī)院體檢中心進行健康體檢的非糖尿病老年人群57例。兩組均排除精神類疾病及老年癡呆等。將非糖尿病老年人群對照組與老年2型糖尿病患者病例組按照年齡、性別及文化程度進行頻數(shù)匹配。(1)ELISA法檢測兩組的BDNF;(2)HPLC法檢測MG;(3)重復(fù)性成套心理狀態(tài)測驗(RBANS)檢測認(rèn)知功能。結(jié)果:老年T2DM組患者的血清BDNF水平4.97±3.05ng/ml,MG的水平67.9nmol/L;正常老年對照組血清BDNF水平11.77±7.92ng/ml,MG的水平43.86nmol/L,兩組數(shù)據(jù)相比,老年T2DM組患者的血清BDNF水平(4.97±3.05ng/ml)與非糖尿病老年人群對照組(11.77±7.92ng/ml)有明顯的下降(P0.01);甲基乙二醛(MG)的水平(67.9nmol/L)比非糖尿病老年人群對照組明顯升高43.86nmol/L(P0.05);并且血清MG升高的水平與血清BDNF下降水平具有一定的相關(guān)性。老年T2DM組和非糖尿病老年人群對照組相比,在認(rèn)知量表標(biāo)準(zhǔn)化測驗總分、視覺廣度、即刻記憶、延時記憶和注意力方面的得分下降較為明顯(PO.05),經(jīng)過多元回歸調(diào)整了年齡以及受教育程度等有可能對得分結(jié)果產(chǎn)生影響的因素后,血清BDNF水平的高低與認(rèn)知量表標(biāo)準(zhǔn)化總分、延時記憶和注意功能的關(guān)聯(lián)依然明顯;老年T2DM組患者血清MG水平的高低與延遲記憶力、即刻記憶力以及量表標(biāo)準(zhǔn)化總分亦有一定的相關(guān)性,具有統(tǒng)計學(xué)意義(P0.05);血清BDNF水平與血清MG水平具有一定的統(tǒng)計相關(guān)性,且呈顯著負(fù)相關(guān)(P=0.0310.05),具有一定的統(tǒng)計學(xué)意義。結(jié)論:1.排除受教育程度以及年齡因素T2DM極有可能是導(dǎo)致患者出現(xiàn)認(rèn)知功能損傷的重要因素,并且比起類似年齡T2DM群體更易發(fā)生aMCI,并且合并出現(xiàn)血清MG水平的升高及血清BDNF水平的下降。2.老年T2DM患者的認(rèn)知功能已經(jīng)表現(xiàn)出與血清MG、血清BDNF的水平具有一定的統(tǒng)計學(xué)相關(guān)性,并且通過進一步統(tǒng)計學(xué)的演算,老年T2DM患者的血清MG升高與血清BDNF的下降亦有一定的關(guān)聯(lián),有可能都參與了認(rèn)知功能損傷的發(fā)病過程。目的:研究運動行為對老年T2DM患者血清BDNF,MG及認(rèn)知功能的影響。方法:本研究采取的是以所在的蘭州大學(xué)第二醫(yī)院內(nèi)分泌病區(qū)、門診以及該院體檢中心為根本的,以頻數(shù)匹配作為方法來選取的病例對照。本研究選取了老年2型糖尿病患者64例,均來自于2014年2月一2015年3月該時間段在蘭州大學(xué)第二醫(yī)院糖尿病2科,3科就診的住院患者(為第一部分糖尿病組),同時排除精神疾病及老年癡呆等。運用行為轉(zhuǎn)變理論對該老年糖尿病組制定運動以及隨訪計劃,采取靶心率,自覺用力程度(RPE)等相關(guān)指標(biāo)監(jiān)控運動強度,并在每位患者手機上安裝微信并教會患者使用微信運動功能。要求每人每天中等強度步行運動35-45分鐘,并且每周運動不能少于5天,在運動開始時要求患者攜帶手機并開機使用微信運動功能,每周通過朋友圈隨訪統(tǒng)計并督促病人進行下周運動。分別在實驗前,參與實驗進行運動后12周,24周分別監(jiān)測血清BDNF,MG及對認(rèn)知功能進行測評。(1)ELISA法檢測兩組的BDNF;(2)HPLC法檢測MG;(3)重復(fù)性成套心理狀態(tài)測驗(RBANS)檢測認(rèn)知功能。結(jié)果:(1)運動進行12周以后,患者的體重、血脂發(fā)生了不同程度的下降;認(rèn)知評估中短時程記憶、長時程記憶有明顯的改善,但對視覺廣度、言語功能的影響不明顯;運動對血清BDNF的水平有一定的提高,但是對改變血清MG的水平變化不明顯。(2)運動24周以后,患者的體重、血脂繼續(xù)不同程度的下降,其中LDL亦出現(xiàn)了明顯的下降;認(rèn)知評估中除了即刻記憶、延時記憶得分仍有繼續(xù)的上升外,言語功能的得分亦出現(xiàn)了具有統(tǒng)計學(xué)意義的提高,但對視覺廣度的影響仍不明顯;此外運動24周對于血清BDNF的水平繼續(xù)有提高,并且血清MG的水平出現(xiàn)了下降。(3)運動24周后與運動12周的指標(biāo)相比,體重、血脂、血糖、認(rèn)知水平得分任然持續(xù)出現(xiàn)改善,而且在運動12周時語言功能及血清MG無明顯改善,但堅持24周的規(guī)律運動后,發(fā)現(xiàn)認(rèn)知項目中言語功能以及血清MG的改善出現(xiàn)了加速的變化。(4)運動干預(yù)24周后,糖尿病組與對照組正常人群相比在即刻記憶、注意力、標(biāo)準(zhǔn)化測驗總分上無明顯差別,但在言語功能、長時程記憶的得分仍顯著低于正常人群。且外周血BDNF、MG的水平與正常人群亦有明顯差異(P0.05)(5)運動干預(yù)時間長短和BMI、TC、LDL、TG、FBG、2h PG、Hb A1c、MG濃度的變化具有一定的負(fù)相關(guān)性,即運動干預(yù)時持續(xù)的間越長,上述各值則下降的明顯;與認(rèn)知測驗中的即刻記憶得分、言語功能得分、注意力得分、延遲記憶得分、標(biāo)化總分、BDNF含量有一定的正相關(guān),即干預(yù)時間越長,各項得分及BDNF含量有明顯的增加。結(jié)論:適當(dāng)?shù)倪\動行為能夠改善BDNF的水平,降低MG含量,并且對認(rèn)知障礙的改善產(chǎn)生積極作用。
[Abstract]:Objective: To investigate the serum BDNF, MG levels in elderly patients with T2DM, the interaction between cognitive function and three. Methods: This study adopts frequency matching methods and cases of normal population were compared. This study selected 64 elderly diabetic 2,3 of Second Hospital Affiliated to Lanzhou University patients with type 2 diabetes patients from February 2014 to March 2015, the time period hospitalized patients. Control group for the same period of time to the Second Hospital Affiliated to Lanzhou University Medical Center for health examination of the elderly non diabetes in 57 cases. Two groups were excluded from the mental diseases and senile dementia. Non diabetic elderly control group and elderly patients with type 2 diabetes mellitus patients according to age, gender and education level were frequency matched (1. BDNF ELISA) were detected in two groups; (2) MG HPLC detection method; (3) repeatability complete mental state test (RBANS) cognitive function test. Results: the elderly group T2DM The level of serum BDNF 4.97 + 3.05ng/ml, the level of 67.9nmol/L MG; normal elderly control group serum BDNF levels was 11.77 + 7.92ng/ml, the level of 43.86nmol/L MG, compared two groups of data, the level of serum BDNF in elderly patients in the T2DM group (4.97 + 3.05ng/ml) and non diabetic elderly control group (11.77 + 7.92ng/ml) decreased significantly B two (P0.01); methyl aldehyde (MG) level (67.9nmol/L) than non-diabetic elderly control group significantly increased 43.86nmol/L (P0.05); and the level of serum BDNF and elevated serum MG level decreased with a certain correlation. Compared with T2DM in the elderly group and non diabetic elderly control group, the cognitive scale standardized test the total score, visual span, immediate memory, delayed memory and attention scores decreased obviously (PO.05), after multivariate regression adjusted for age and education level are likely to score the results The influence of the factors, serum BDNF level and cognitive scale standardization association scores, delayed memory and attention function is still evident in elderly patients in the T2DM group; the serum level of MG and delay memory, immediate memory and scale standardized scores have a certain correlation with statistical significance (P0.05); serum the level of BDNF and the level of serum MG has certain statistical correlations, and showed significant negative correlation (P=0.0310.05), with statistical significance. Conclusion: 1. out of education and age factors of T2DM may be an important factor leading to cognitive impairment in patients with T2DM and compared with similar age groups are more prone to aMCI, and with the increase of serum MG level and serum BDNF level of.2. decreased in elderly patients with T2DM cognitive function has been demonstrated with serum MG, serum BDNF level has a certain Statistical correlation, and through further statistical calculation of serum MG in elderly patients with T2DM also increased is related to decreased and serum BDNF, may be involved in the pathogenesis of cognitive impairment. Objective: To study the behaviors of elderly T2DM patients serum BDNF, MG and cognitive function. Methods: This study adopted is located in Second Hospital Affiliated to Lanzhou University endocrine ward, outpatient and hospital medical center as the fundamental, as to frequency matching method to select case control. This study selected 64 cases of elderly patients with type 2 diabetes, from February 2014 to March 2015 this period of time in the Second Hospital Affiliated to Lanzhou University 2 diabetes department, inpatient hospital (3 for the first part, diabetes group) while excluding mental illness and dementia. The use of behavioral change theory for the elderly diabetes group for movement And follow-up plan, take the target rate, degree of perceived exertion (RPE) exercise intensity monitoring and other related indicators, and in each patient on the installation of WeChat mobile phone and use WeChat motor function of patients. The church required per person per day of moderate intensity exercise 35-45 minutes walk, and not less than 5 days a week, for patients to carry mobile phone and start to use WeChat motor function at the beginning of the movement, a circle of friends through the follow-up statistics and urge patients next week exercise. Respectively before the experiment, 12 weeks in the experimental exercise after 24 weeks respectively monitoring serum BDNF, MG and evaluation of cognitive function. (1) BDNF ELISA was detected in two groups; (2) the detection of MG HPLC method; (3) repeatability complete mental state test (RBANS) cognitive function test. Results: (1) after exercise for 12 weeks, the weight of the patient, the decreased blood lipid; short-term memory cognitive assessment in a long time The long-term memory has improved significantly, but the breadth of vision, speech function is not obvious; the level of exercise on serum BDNF has been improved to a certain extent, but the change of serum MG level change is not obvious. (2) 24 weeks later, the patient's body weight, blood lipids to different degrees of decline, which also appeared in LDL a significant decline in cognitive assessment; in addition to immediate memory, delayed memory score is still on the rise, speech function scores also had statistically significant increase, but the impact on the breadth of vision is still not clear; in addition to exercise for 24 weeks for serum BDNF levels continue to improve, and the level of serum MG the decline. (3) compared to exercise after 24 weeks and 12 weeks of exercise index weight, blood lipid, blood glucose, scores of cognitive level still continued to improve and in the exercise for 12 weeks when the language function and serum MG had no obvious improvement, but insist on 24 weeks Regular exercise, found that cognitive project and improve speech function of serum MG appeared to accelerate the change. (4) after 24 weeks of exercise intervention, diabetes group attention in the immediate memory, compared with the control group, normal group, there was no significant difference between the standard test scores, but in language, the long term memory scores is still lower than that of normal people. And peripheral blood BDNF, MG levels and normal people also have obvious difference (P0.05) (5) exercise intervention duration and BMI, TC, LDL, TG, FBG, 2h PG, Hb A1c, has negative correlation with certain MG concentration changes, namely continuous exercise intervention the longer the value decreased significantly; and the scores of cognitive tests of immediate memory, verbal function score, attention scores, delayed memory score, standard score, there is a positive relationship between the content of BDNF, namely, the longer the intervention, the scores were increased and the content of BDNF. Conclusion: appropriate exercise behavior can improve the level of BDNF, reduce the content of MG, and have a positive effect on the improvement of cognitive impairment.

【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R587.2

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6 張超群；范曉莉;認(rèn)知功能與腦結(jié)構(gòu)測量有相關(guān)性[N];中國醫(yī)藥報;2005年

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相關(guān)博士學(xué)位論文 前10條

1 虎子穎;糖尿病認(rèn)知功能與海馬體積及生化物質(zhì)的相關(guān)性研究[D];鄭州大學(xué);2013年

2 夏蘭;失眠障礙患者認(rèn)知功能與客觀睡眠、神經(jīng)內(nèi)分泌、細(xì)胞因子狀態(tài)的臨床研究[D];安徽醫(yī)科大學(xué);2014年

3 王天成;特發(fā)性全面性癲癇的認(rèn)知功能研究[D];重慶醫(yī)科大學(xué);2014年

4 解恒革;老年男性認(rèn)知功能衰退與血清睪酮和雌二醇的關(guān)系[D];中國人民解放軍軍醫(yī)進修學(xué)院;2004年

5 苗茂華;太原市社區(qū)老年人認(rèn)知功能下降的影響因素研究[D];山西醫(yī)科大學(xué);2005年

6 吳燕t

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