本文選題：代謝綜合征 + 皮質(zhì)下缺血性血管病��； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的采用改良Scheltens量表對(duì)皮質(zhì)下缺血性血管�。⊿IVD）影像學(xué)上腦損害進(jìn)行評(píng)價(jià)，分為腦室旁（PVH）、腦白質(zhì)（WMH）、基底節(jié)（BG）三個(gè)腦區(qū)評(píng)定并量化；Mets的診斷標(biāo)準(zhǔn)采用NCEP-ATP III標(biāo)準(zhǔn)。探討代謝綜合征（Mets）及其各因子對(duì)SIVD各個(gè)腦區(qū)腦損害的影響。 材料與方法選取2012年9月-2013年6月安徽醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科SIVD患者120例（SIVD組），其中包括非代謝綜合征（No-Mets）患者25例，代謝綜合征傾向（R-Mets）患者25例，Mets患者70例。Mets的診斷標(biāo)準(zhǔn)采用NCEP-ATPIII標(biāo)準(zhǔn)，受試對(duì)象均在空腹?fàn)顟B(tài)下采集血液樣本用于檢測(cè)血糖、TG及HDL-C，并測(cè)量身高、體重以及腰圍，在休息5分鐘后測(cè)量血壓并記錄。SIVD腦損害采用改良Scheltens量表對(duì)頭顱MRI進(jìn)行評(píng)價(jià)，，分為腦室旁（PVH）（0-6分）、腦白質(zhì)（WMH）（0-24分）、基底節(jié)（BG）（0-30分）三個(gè)腦區(qū)評(píng)定并計(jì)算總分。本研究采用SPSS16.0軟件對(duì)數(shù)據(jù)進(jìn)行了統(tǒng)計(jì)學(xué)處理，分析Mets及其各因子對(duì)SIVD各個(gè)腦區(qū)腦損害的影響。 結(jié)果（1）R-Mets組和Mets組PVH、WMH、BG評(píng)分、Scheltens總分均顯著高于No-Mets組（P均＜0.05）。（2）腰圍與WMH評(píng)分及Scheltens總分呈顯著正相關(guān)（P均＜0.05）；甘油三酯（TG）與WMH、BG評(píng)分有顯著正相關(guān)（P＜0.05)；空腹血糖（FPG）與WMH、BG評(píng)分以及Scheltens總分呈顯著正相關(guān)(P＜0.05)；高密度脂蛋白（HDL-C）與WMH、BG評(píng)分以及Scheltens總分呈顯著負(fù)相關(guān)(P＜0.05)。（3）進(jìn)一步多元線性逐步回歸分析結(jié)果發(fā)現(xiàn)FPG、HDL-C與WMH評(píng)分顯著相關(guān)(P均＜0.05)；TG與BG評(píng)分顯著相關(guān)(P＜0.05)；腰圍、FPG、HDL-C與Scheltens總分顯著相關(guān)(P均＜0.05)。 結(jié)論 （1）R-Mets組和Mets組影像學(xué)評(píng)分較No-Mets組均顯著增高；Mets組的WMH、BG評(píng)分、Scheltens總分顯著高于R-Mets組； （2）腰圍與WMH評(píng)分及Scheltens總分呈顯著正相關(guān)；TG與WMH、BG評(píng)分有顯著正相關(guān)；FPG與WMH、BG評(píng)分以及Scheltens總分呈顯著正相關(guān)；HDL-C與WMH、BG評(píng)分以及Scheltens總分呈顯著負(fù)相關(guān)。（3）Mets及其各因子與SIVD腦損害相關(guān)，其中腹型肥胖、TG、FPG、HDL-C是SIVD 的重要危險(xiǎn)因素。
[Abstract]:Objective to evaluate the imaging brain damage of subcortical ischemic vascular disease (Scheltens) by modified Scheltens scale, and divide it into three brain regions: PVHN, WMHG and BGs. NCEP-ATP III was used to evaluate and quantify the diagnostic criteria of subcortical ischemic vascular disease (SIVD).Objective: to investigate the effects of Metabolic Syndrome (Metals) and its factors on brain damage in various brain regions of SIVD.Materials and methods from September 2012 to June 2013, 120 patients with SIVD in Department of Neurology, first affiliated Hospital of Anhui Medical University, including 25 patients with non-metabolic syndrome No-Mets, were selected.NCEP-ATPIII criteria were used in the diagnosis of 25 patients with Metabolic Syndrome (R-Mets) and 70 patients with Mets. Blood samples were collected on an empty stomach to detect TG and HDL-C, and height, weight and waist circumference were measured.After 5 minutes rest, the blood pressure was measured and the brain damage of SIVD was evaluated by modified Scheltens scale. The results were divided into three brain regions: paraventricular MRI (0-6), white matter (WMH) 0-24, basal ganglia (BGG) 0-30).In this study, SPSS16.0 software was used to analyze the effects of Mets and its factors on the brain damage in various brain regions of SIVD.Results the total score of Mets group and R-Mets group were significantly higher than that of No-Mets group (P < 0.05, P < 0.05) the waist circumference was positively correlated with WMH score and Scheltens score (P < 0.05), there was a significant positive correlation between TGG and WMHBG score (P < 0.05), fasting blood glucose (FBG) and WMHHG score and Scheltens score were significantly higher than those in No-Mets group (P < 0.05), and there was a significant positive correlation between WMH score and Scheltens score (P < 0.05), and there was a significant positive correlation between TGG and WMHBG score (P < 0.05), FBG score and WMHHG score (P < 0.05).There was significant positive correlation between HDL-C and Scheltens score (P < 0.05), and significant negative correlation between HDL-C and Scheltens score (P < 0.05). Further stepwise regression analysis showed that HDL-C was significantly correlated with WMH score (P < 0.05), and there was significant correlation between HDL-C and BG score (all P < 0.05), and there was a significant correlation between HDL-C and WMH score (P < 0.05), and significant correlation (P < 0.05) between HDL-C and Scheltens score (P < 0.05), and significant correlation (P < 0.05) between HDL-C and WMH score (P < 0.05).There was significant correlation between HDL-C and total score of Scheltens (P < 0.05).ConclusionThe imaging scores of R-Mets group and Mets group were significantly higher than those of No-Mets group.(2) there was a significant positive correlation between waist circumference and WMH score and total Scheltens score. There was a significant positive correlation between TG and WMHBG score and Scheltens score. There was a significant negative correlation between HDL-C and WMHHBG score, and a significant negative correlation between Scheltens total score and SIVD brain damage.The HDL-C of the abdominal obesity group is SIVD.Important risk factors.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R589;R743

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