本文選題：帕金森病 + 帕金森病癡呆��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本試驗通過檢測血促甲狀腺素(TSH)、游離三碘甲狀原氨酸(FT3)、游離甲狀腺素(FT4)、促腎上腺皮質(zhì)激素(ACTH)、皮質(zhì)醇(cortisol)、糖化血紅蛋白(HbAlc)來說明神經(jīng)內(nèi)分泌變化對帕金森病非癡呆患者及帕金森病癡呆患者的影響,進(jìn)一步探討帕金森病及其認(rèn)知障礙與神經(jīng)內(nèi)分泌間的潛在關(guān)系,為預(yù)防帕金森病癡呆提供依據(jù)。方法:收集2015年12月1日-2016月12月30日山西醫(yī)科大學(xué)第一醫(yī)院確診的帕金森病非癡呆患者(n-PDD)42例,帕金森病癡呆患者(PDD)21例及同期對照組20例,收集其一般臨床資料如性別、年齡、受教育年限、病程及H-Y分級;由兩名專業(yè)的神經(jīng)心理測評員對其進(jìn)行MMSE評分及ADL評分,對PDD組進(jìn)行NPI評分;于晨起6時空腹?fàn)顟B(tài)下抽取靜脈血15ml,用全自動生化儀檢測血TSH、FT3、FT4、ACTH、皮質(zhì)醇、HbAlc,采用統(tǒng)計軟件SPSS21.0處理數(shù)據(jù),定量資料表示為均數(shù)±標(biāo)準(zhǔn)差,兩組均數(shù)間的比較采用兩獨(dú)立樣本t檢驗,多組均數(shù)比較采用單變量方差分析,多個樣本均數(shù)間的多重比較,采用LSD-t檢驗,P0.05認(rèn)為差異有統(tǒng)計學(xué)意義。結(jié)果:PDD組、n-PDD組的年齡,受教育年限的差異無統(tǒng)計學(xué)的意義(P0.05);病程、H-Y分級的差異有統(tǒng)計學(xué)的意義(P0.05),PDD組的病程較長,H-Y分級較高。HPT軸:PDD組、n-PDD、對照組的TSH分別為:2.79±1.11、2.74±1.03、2.04±0.86,PDD組、n-PDD、對照組的FT3分別為:4.28±0.77、4.41±0.69、4.86±0.96,PDD組、n-PDD、對照組的FT4分別為:14.99±2.35、14.77±2.65、13.22±2.19,PDD組、n-PDD組的TSH、FT3、FT4與對照組相比,差異有統(tǒng)計學(xué)意義(P0.05),PDD組、n-PDD組兩組間上述指標(biāo)的比較差異無統(tǒng)計學(xué)意義(P0.05),PDD組、n-PDD組的TSH、FT4比對照組高,FT3比對照組低。HPA軸:PDD組、n-PDD組、對照組的ACTH分別為:7.15±2.75、7.96±2.61、9.70±3.65,PDD組、n-PDD組、對照組的皮質(zhì)醇分別為:431.87±170.63、351.21±133.90、330.02±106.76,PDD組、n-PDD組的ACTH與對照組相比,差異有統(tǒng)計學(xué)意義(P0.05),PDD組、n-PDD組間ACTH的比較差異無統(tǒng)計學(xué)意義(P0.05),PDD組與n-PDD組、對照組的皮質(zhì)醇相比,差異有統(tǒng)計學(xué)意義(P0.05),n-PDD、對照組的皮質(zhì)醇的比較,差異無統(tǒng)計學(xué)意義(P0.05),PDD、n-PDD組的ACTH比對照組低,PDD組的皮質(zhì)醇高于n-PDD與對照組。PDD組、n-PDD組、對照組的HbAlc分別為:6.01±0.59、5.91±0.84、5.41±0.42。PDD組、n-PDD組的HbAlc與對照組相比,差異有統(tǒng)計學(xué)意義(P0.05),PDD組、n-PDD組間HbAlc的比較,差異無統(tǒng)計學(xué)意義(P0.05),PDD、n-PDD組的HbAlc比對照組高。結(jié)論:帕金森病癡呆與帕金森病非癡呆患者的血TSH、FT4、HbAlc水平較高,血ACTH、FT3水平低下,帕金森病癡呆患者的血皮質(zhì)醇增高。血TSH、FT4、FT3、HbAlc、ACTH對帕金森病癡呆可能無影響,血皮質(zhì)醇水平升高對帕金森病癡呆可能有一定的影響。神經(jīng)內(nèi)分泌變化可為預(yù)防帕金森病癡呆提供依據(jù)。
[Abstract]:Objective: to investigate the effect of neuroendocrine changes on Parkinson's disease (PD) by detecting TSH, free triiodothyronine, free thyroxine FT4, adrenocorticotropic hormone (ACTH), cortisol cortisola and glycosylated hemoglobin (HbAlc). The effects of dementia and Parkinson's disease, To further explore the potential relationship between Parkinson's disease, its cognitive impairment and neuroendocrine, and to provide evidence for the prevention of Parkinson's disease dementia. Methods: from December 1, 2015 to December 30, 2010, 42 patients with Parkinson's disease diagnosed as non-dementia, 21 patients with Parkinson's disease with PDD and 20 controls were collected. The general clinical data such as sex and age were collected. The length of education, course of disease and H-Y grade were evaluated by two professional neuropsychological evaluators on MMSE score and ADL score, and NPI score on PDD group. Venous blood was collected at 6 am at 6 am. Blood TSHFT3FT4FT4ACTH, cortisol HbAlc were detected by automatic biochemical instrument. The data were processed by statistical software SPSS21.0, and the quantitative data were expressed as mean 鹵standard deviation. The comparison between the two groups was performed by two independent samples t test. The multigroup mean was compared by univariate analysis of variance and the multiple comparison between the mean of multiple samples. The difference was statistically significant by using LSD-t test (P0.05). Results the age of the 20% PDD group was compared with that of the n-PDD group. There was no significant difference in the number of years of education (P 0.05), but there was significant difference in the course of disease (P 0.05) and the FT3 of the control group was: 4.28 鹵0.774.41 鹵0.774.41 鹵0.69 鹵0.96 鹵0.96 鹵0.96 鹵0.96 鹵0.96 鹵0.96 鹵0.96; The FT4 of the control group was 14. 99 鹵2. 35 鹵14. 77 鹵2. 65 and 13. 22 鹵2. 19 respectively. Compared with the control group, the FT4 of the n-PDD group was higher than that of the control group. There was no significant difference in the above indexes between the two groups. The ACTH of the control group was lower than that of the control group. The ACTH of the control group was 7. 15 鹵2. 75 鹵2. 71 鹵2. 61 鹵9. 70 鹵3. 65% and that of the control group was 7. 15 鹵2. 75 鹵2. 61 鹵9. 70 鹵3. 65% respectively. The ACTH of n-PDD group was significantly higher than that of control group (P 0.05). There was no significant difference in ACTH between P0.05PDD group and n-PDD group, and there was no significant difference in cortisol between P0.05PDD group and n-PDD group. There was no significant difference in cortisol between the control group and the control group. The ACTH of the PDD group was higher than that of the control group, and the HbAlc of the control group was 6.01 鹵0.595.91 鹵0.84 鹵0.84 鹵0.42.PDD and that of the control group was higher than that of the control group. There was no significant difference in HbAlc between P0.05 and PDD groups. The HbAlc of the P0.05-PDD n-PDD group was higher than that of the control group. Conclusion: the serum levels of TSHFT4 and HbAlc in patients with Parkinson's disease and Parkinson's disease are higher than those in patients with Parkinson's disease, and the levels of ACTH / FT3 are lower, and cortisol is higher in patients with dementia with Parkinson's disease. The serum TSHFT4 FT3 HbAlcACTH may have no effect on Parkinson's disease dementia, but elevated serum cortisol level may have a certain effect on Parkinson's disease dementia. Neuroendocrine changes may provide evidence for the prevention of Parkinson's disease dementia.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R742.5

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