發(fā)布時(shí)間：2018-03-10 21:03

  本文選題：腦梗死　切入點(diǎn)：腦白質(zhì)病變　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討同型半胱氨酸(Hcy)、血尿酸(UA)水平與腦梗死患者腦白質(zhì)病變(WMLs)嚴(yán)重程度及認(rèn)識(shí)功能的相關(guān)性。方法:選取201選取同期腦梗死合并腦白質(zhì)病變患者中的200例作為觀察組,采用酶聯(lián)免疫吸附法和尿酸氧化酶法分別檢測(cè)兩組患者血清中的Hcy、UA水平。將腦梗死合并腦白質(zhì)病變患者根據(jù)TOAST分5年5月至2016年11月我院神經(jīng)內(nèi)科收治的腦梗死患者中的200例作為對(duì)照組,另外型進(jìn)行分組,比較大動(dòng)脈粥樣硬化性腦梗死(LAA)、小動(dòng)脈閉塞性腦梗死(SAO)和心源性腦梗死(CE)三組患者血清中的Hcy、UA水平,并采用北京版蒙特利爾認(rèn)知評(píng)估量表(Mo CA)進(jìn)行評(píng)分比較;將LAA、SAO和CE三組患者分別依據(jù)腦白質(zhì)病變的嚴(yán)重程度分為輕度組、中度組和重度組,比較每個(gè)TOAST分型腦梗死不同病變程度患者血清中的Hcy、UA水平及Mo CA評(píng)分。對(duì)腦梗死合并腦白質(zhì)病變患者持續(xù)治療28d后,比較治療前后患者血清中的Hcy、UA水平及Mo CA評(píng)分。結(jié)果:1、觀察組患者血清中Hcy、UA水平均明顯高于對(duì)照組,兩組患者二者水平的差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。2、不同TOAST分型腦梗死患者血清中Hcy、UA水平及Mo CA評(píng)分LAA組患者血清中Hcy、UA水平均明顯高于SAO組和CE組患者,其差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);而SAO組和CE組患者間的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組患者的Mo CA評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3、LAA型腦梗死患者血清中Hcy、UA水平均隨腦白質(zhì)病變的嚴(yán)重程度而升高,Mo CA評(píng)分則隨腦白質(zhì)病變的嚴(yán)重程度而減少,其差異亦均具有統(tǒng)計(jì)學(xué)意義(P0.05);SAO型腦梗死患者血清中Hcy、UA水平均隨腦白質(zhì)病變的嚴(yán)重程度而升高,Mo CA評(píng)分則隨腦白質(zhì)病變的嚴(yán)重程度而減少,其差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);CE型腦梗死患者血清中Hcy、UA水平均隨腦白質(zhì)病變的嚴(yán)重程度而升高,Mo CA評(píng)分則隨腦白質(zhì)病變的嚴(yán)重程度而減少,其差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。4、CE型腦梗死患者血清中Hcy、UA水平均隨腦白質(zhì)病變的嚴(yán)重程度而升高,Mo CA評(píng)分則隨腦白質(zhì)病變的嚴(yán)重程度而減少,其差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:腦梗死患者腦白質(zhì)病變的嚴(yán)重程度隨其血清中的Hcy、UA水平升高而加重,且其認(rèn)知功能隨患者血清中的Hcy、UA水平升高而降低,Hcy、UA水平與腦梗死患者腦白質(zhì)病變的嚴(yán)重程度及認(rèn)知功能存在相關(guān)性。
[Abstract]:Objective: to investigate the correlation between the level of homocysteine cystatin (HcyN) and serum uric acid (UAA) and the severity and cognitive function of white matter lesions (WMLs) in patients with cerebral infarction. Methods: 200 patients with cerebral infarction complicated with white matter disease were selected as the observation group. The serum levels of cyclosporin UA in patients with cerebral infarction and leukoencephalopathy were determined by Elisa and uric acid oxidase methods. According to TOAST, the patients were divided into 5 years from May to November 2016. The patients with cerebral infarction were treated in neurology department of our hospital from May to November 2016. 200 of the patients served as the control group, The other type was divided into three groups. The serum levels of Hcyanthera in the three groups of patients with Atherosclerotic cerebral infarction (ACA), arterio-occlusive cerebral infarction (SAO) and cardiogenic cerebral infarction (CEE) were compared, and the scores were compared with Beijing Montreal Cognitive Assessment scale (MOCA). According to the severity of white matter lesions, the patients in LAANASAO and CE groups were divided into three groups: mild group, moderate group and severe group. The serum levels of cystatin UA and MoCA were compared in patients with different degrees of cerebral infarction according to TOAST classification. After 28 days of continuous treatment, the patients with cerebral infarction complicated with white matter disease were treated continuously for 28 days. Results the serum levels of Hcylla in the observation group were significantly higher than those in the control group, and the scores of Mo CA in the patients before and after the treatment were compared with those in the control group. The difference between the two groups was statistically significant (P < 0.05). The serum levels of cystatin UA in patients with cerebral infarction of different TOAST classification and Mo CA score in LAA group were significantly higher than those in SAO group and CE group. There was no significant difference between SAO group and CE group (P 0.05). There was no significant difference in Mo CA score between the three groups. The increase of Mo CA score decreased with the severity of leukoencephalopathy. The difference was also statistically significant in the patients with P0.05 or SAO type cerebral infarction. The serum levels of Hcynica UA increased with the severity of white matter lesions, but the Mo CA scores decreased with the severity of white matter lesions. The differences were statistically significant. The serum levels of Hcynica in patients with CE type cerebral infarction were increased with the severity of leukoencephalopathy, and the scores of Mo CA were decreased with the severity of white matter lesions. The difference was statistically significant in patients with cerebral infarction of type P0.05. 4. The serum levels of Hcyn UA increased with the severity of white matter lesions, but the scores of Mo CA decreased with the severity of white matter lesions. Conclusion: the severity of cerebral white matter lesions in patients with cerebral infarction is aggravated by the increase of serum levels of cystatin UA. The cognitive function decreased with the increase of serum Hcynica level and correlated with the severity of cerebral white matter lesions and cognitive function in patients with cerebral infarction.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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