【摘要】：目的本實(shí)驗(yàn)通過(guò)檢測(cè)2型糖尿病(Type 2 diabetes mellitus,T2DM)患者白介素18(Interleukin,IL-18)和脂聯(lián)素(Adiponectin,APN)水平,探討T2DM患者血清IL-18和APN水平與認(rèn)知功能的關(guān)系,及其各自的影響因素。方法1研究對(duì)象病例組選自2013年3月至2014年3月于唐山市工人醫(yī)院內(nèi)分泌二科住院的T2DM患者65例,男36例,女29例。另外,正常對(duì)照組于唐山工人醫(yī)院院體檢中心選取,共50例,男27例,女23例,兩組年齡匹配。病例組中,根據(jù)IL-18水平是否大于其均數(shù)分為IL-18-H、IL-18-L兩組,同理,脂聯(lián)素分為APN-H、APN-L兩組。2研究方法采集受試者肘靜脈血,于抽血當(dāng)天測(cè)定受試者FPG、Hb A1c、TC、TG、HDL、LDL等臨床指標(biāo),并進(jìn)行RBANS量表測(cè)試。制定一般情況調(diào)查表,收集受試者一般資料包括:性別、年齡、教育程度、病程、體重指數(shù)(body mass index,BMI)。采用酶聯(lián)免疫吸附法(Enzyme linked immunosorbent assay,ELLSA)測(cè)定血清IL-18、APN水平,上述資料應(yīng)用SPSS17.0進(jìn)行統(tǒng)計(jì)分析結(jié)果1病例組TG、FPG、Hb A1c、IL-18水平高于對(duì)照組,HDL、APN水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),兩組其余指標(biāo)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2病例組即時(shí)記憶分?jǐn)?shù)及標(biāo)準(zhǔn)分低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但兩組視覺(jué)廣度分?jǐn)?shù)、言語(yǔ)功能分?jǐn)?shù)、注意力分?jǐn)?shù)、延遲記憶分?jǐn)?shù)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3 IL-18-H組即時(shí)記憶分?jǐn)?shù)、言語(yǔ)功能分?jǐn)?shù)、注意力分?jǐn)?shù)、延遲記憶分?jǐn)?shù)及標(biāo)準(zhǔn)分低于IL-18-L組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),視覺(jué)廣度分?jǐn)?shù)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);APN-H組與APN-L組比較,APN-H組即時(shí)記憶分?jǐn)?shù)、注意力分?jǐn)?shù)、標(biāo)準(zhǔn)分高于APN-L組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),視覺(jué)廣度分?jǐn)?shù)、言語(yǔ)功能分?jǐn)?shù)、延遲記憶分?jǐn)?shù)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4 IL-18水平與年齡、FPG、Hb A1c呈正相關(guān),與APN水平、即時(shí)記憶分?jǐn)?shù)、言語(yǔ)功能分?jǐn)?shù)、注意力分?jǐn)?shù)、延遲記憶分?jǐn)?shù)、標(biāo)準(zhǔn)分呈負(fù)相關(guān)(P0.05);APN水平與Hb A1C、IL-18水平呈負(fù)相關(guān),與即時(shí)記憶分?jǐn)?shù)、注意力分?jǐn)?shù)、標(biāo)準(zhǔn)分呈正相關(guān)(P0.05)。5以IL-18為應(yīng)變量,APN、性別、年齡、教育程度、BMI、TC、TG、HDL、LDL、FPG、Hb A1c、病程為自變量進(jìn)行多元逐步回歸分析,進(jìn)入回歸方程的有:年齡、Hb A1c、APN;以APN為應(yīng)變量,IL-18、性別、年齡、教育程度、BMI、TC、TG、HDL、LDL、FPG、Hb A1c、病程為自變量進(jìn)行多元逐步回歸分析,進(jìn)入回歸方程的有:IL-18、TC;分別以即時(shí)記憶分?jǐn)?shù)、視覺(jué)廣度分?jǐn)?shù)、言語(yǔ)功能分?jǐn)?shù)、注意力分?jǐn)?shù)、延遲記憶分?jǐn)?shù)、標(biāo)準(zhǔn)分為應(yīng)變量,IL-18、APN、性別、年齡、教育程度、BMI、TC、TG、HDL、LDL、FPG、Hb A1c、病程為自變量進(jìn)行多元逐步回歸分析,進(jìn)入方程的分別有:教育程度、IL-18;病程;年齡、教育程度;年齡、教育程度、IL-18、APN;IL-18;年齡、教育程度、IL-18、APN。結(jié)論1 T2DM患者存在炎癥狀態(tài),其血清IL-18水平顯著升高、APN水平顯著降低,并伴隨認(rèn)知功能損傷。2隨著IL-18水平的升高和APN水平的降低T2DM患者的認(rèn)知功能顯著下降。3 APN可能通過(guò)抗炎機(jī)制改善認(rèn)知功能。
[Abstract]:Objective to investigate the relationship between serum levels of interleukin-18 (Interleukin,IL-18) and adiponectin (Adiponectin,APN) in patients with type 2 diabetes mellitus (Type-2 diabetes mellitus,T2DM) and cognitive function by measuring serum levels of IL-18 and APN in patients with type 2 diabetes mellitus (T2DM). And their respective influencing factors. Methods (1) 65 patients (36 males and 29 females) with T2DM were selected from March 2013 to March 2014 in the second Department of Endocrinology of Tangshan Workers' Hospital. In addition, the normal control group was selected from the physical examination center of Tangshan Workers Hospital. There were 50 cases, 27 males and 23 females. The age of the two groups was matched. In the case group, the patients were divided into two groups according to whether or not IL-18 level was greater than its mean. Similarly, adiponectin was divided into two groups: APN-H,APN-L group and control group. (2) Blood samples were collected from the elbow vein of the subjects. The clinical indexes such as FPG,Hb A1C, TC, TG, HDL, LDL were measured on the day of blood sampling, and the RBANS scale was used. A general questionnaire was developed to collect subjects' general data including: sex, age, education level, course of disease, body mass index (body mass index,BMI). The level of serum IL-18,APN was measured by enzyme-linked immunosorbent assay (Enzyme linked immunosorbent assay,ELLSA). The above data were analyzed by SPSS17.0. The results showed that the levels of TG,FPG,Hb A1c and IL-18 in the case group were higher than those in the control group, HDL,. APN level was lower than the control group, the difference was statistically significant (P0.05), there was no significant difference in other indicators between the two groups (P0.05). 2 the immediate memory score and standard score in the case group were lower than those in the control group, the difference was statistically significant (P0.05). But there was no significant difference in visual span score, speech function score, attention score and delayed memory score between the two groups (P0.05). 3 in IL-18-H group, immediate memory score, speech function score and attention score were not significantly different (P0.05). Delayed memory scores and standard scores were lower than those in IL-18-L group (P0.05), but visual breadth scores had no significant difference (P0.05). Compared with APN-L group, the instant memory score, attention score and standard score in APN-H group were higher than those in APN-L group (P0.05), visual breadth score, speech function score, and so on. There was no significant difference in delayed memory score (P0.05). 4 IL-18 level was positively correlated with age, FPG,Hb A1c, APN level, instant memory score, speech function score, attention score and delayed memory score. The standard score was negatively correlated (P0.05); APN level was negatively correlated with Hb A1C, IL-18 level, and positively correlated with instant memory score, attention score and standard score (P0.05). 5 IL-18 was used as dependent variable, APN, sex, age, education level, BMI,TC,TG,HDL,LDL,. FPG,Hb A1c, course of disease as independent variable for multiple stepwise regression analysis, entered the regression equation are: age, Hb A1c, APN; Taking APN as dependent variable, IL-18, sex, age, education level, BMI,TC,TG,HDL,LDL,FPG,Hb A1c and course of disease as independent variables, the multiple stepwise regression analysis was carried out. The regression equation was IL-18,TC;. According to immediate memory score, visual span score, speech function score, attention score, delayed memory score, IL-18,APN, gender, age, education level, BMI,TC,TG,HDL,LDL,FPG,Hb A1c, the standard was classified as dependent variable, visual span score, speech function score, attention score and delayed memory score. The course of disease was independent variable and the multiple stepwise regression analysis was carried out. The entry equations were: education level, IL-18;. Course of disease; age, education level, IL-18,APN;IL-18; age, education level, IL-18,APN. Conclusion (1) there is inflammatory state in T2DM patients. The level of serum IL-18 is significantly higher and the level of APN is significantly lower in patients with SARS. 2 with the increase of IL-18 level and the decrease of APN level, the cognitive function of T2DM patients decreased significantly. 3 APN may improve cognitive function through anti-inflammatory mechanism.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R587.1

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