本文選題：圍絕經(jīng)期 + 雌二醇　； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:近年來我國(guó)老齡化現(xiàn)象日益加重,每年約有幾十萬(wàn)的女性經(jīng)歷圍絕經(jīng)期,女性圍絕經(jīng)期癥狀主要是記憶力減退、學(xué)習(xí)能力下降、抑郁、焦慮等,且圍絕經(jīng)期主要生理變化是性激素水平的波動(dòng)。海馬是大腦中涉及學(xué)習(xí)和記憶的功能區(qū)域,在中樞神經(jīng)退行性疾病的發(fā)生與發(fā)展中起到重要的作用。磁共振波譜學(xué)是磁共振檢查技術(shù)中的生化代謝分析,是非侵入性測(cè)定活體組織中相應(yīng)化合物組成成分及其含量的影像學(xué)檢測(cè)技術(shù),因組織的生物學(xué)改變常常先于形態(tài)學(xué)改變,所以它在分析和探討女性不同性激素水平與海馬區(qū)細(xì)胞代謝物之間的聯(lián)系作用方面具有不可替代的應(yīng)用價(jià)值。因此,全面研究不同血清性激素水平與海馬組織代謝物的聯(lián)系變化規(guī)律,有助于為累及海馬的相關(guān)疾病如衰老、Alzheimer病等的鑒別與早期診斷提供可靠的影像學(xué)參考依據(jù)。方法:選取圍絕經(jīng)期女性31例(圍絕經(jīng)期組)、健康年輕女性31例(健康年輕組),均收集年齡、體重、身高等基本信息;選用3.0T磁共振氫質(zhì)子波譜技術(shù)采集所有志愿者大腦半球雙側(cè)海馬(與學(xué)習(xí)和記憶相關(guān)的區(qū)域)的代謝物即N-乙酰天冬氨酸(NAA)、總肌酸(Cr)、膽堿(Cho)的濃度,以及測(cè)定每位女性血清雌二醇、促黃體生成素、促卵泡刺激素、孕酮、睪酮水平。資料均采用獨(dú)立樣本t檢驗(yàn)、Pearson相關(guān)進(jìn)行統(tǒng)計(jì)學(xué)分析。成果:圍絕經(jīng)期組和健康年輕組相比,血清雌二醇水平顯著降低(P=0.000);血清促卵泡刺激素水平顯著降低(P=0.012);血清睪酮水平顯著降低(P=0.000);右側(cè)海馬NAA/Cr顯著降低(P=0.013),右側(cè)海馬NAA/(Cr+Cho)顯著降低(P=0.006)。經(jīng)配對(duì)t檢驗(yàn),圍絕經(jīng)期組女性海馬NAA/Cr左右側(cè)具有顯著差異(P=0.010);圍絕經(jīng)期組女性海馬NAA/(Cr+Cho)左右側(cè)具有顯著差異(P=0.004)。健康年輕組女性海馬NAA/Cr左右側(cè)具有顯著差異(P=0.012),健康年輕組女性海馬NAA/(Cr+Cho)左右側(cè)具有顯著差異(P=0.002)。Pearson相關(guān)分析表明,健康年輕組女性血清雌二醇水平與左側(cè)海馬NAA/Cr、左側(cè)NAA/(Cr+Cho)、右側(cè)海馬NAA/Cr、右側(cè)NAA/(Cr+Cho)之間存在正相關(guān)(P=0.001、P=0.000、P=0.022、P=0.034)。圍絕經(jīng)期組女性血清促黃體生成素水平與左側(cè)海馬NAA/Cr、左側(cè)海馬Cho/Cr、左側(cè)海馬NAA/(Cr+Cho)、右側(cè)海馬 NAA/(Cr+Cho)之間存在負(fù)相關(guān)(P=0.007、P=0.044、P=0.014、P=0.028);圍絕經(jīng)期組女性血清睪酮與右側(cè)海馬Cho/Cr之間存在正相關(guān)(P=0.027);圍絕經(jīng)期組女性年齡與右側(cè)海馬NAA/Cr之間存在負(fù)相關(guān)(P=0.047)。結(jié)論:健康年輕女性血清雌二醇水平越高,海馬左右側(cè)NAA/Cr、NAA/(Cr+Cho)越高;圍絕經(jīng)期女性血清促黃體生成素水平越高,海馬左側(cè)NAA/Cr、海馬左右側(cè)NAA/(Cr+Cho)越低;女性血清雌二醇、促黃體生成素等可能通過某種機(jī)制影響了海馬的代謝。
[Abstract]:Objective: in recent years, the aging phenomenon in China has become more and more serious. Hundreds of thousands of women experience peri-menopausal period every year. The symptoms of menopause are mainly memory loss, learning ability decline, depression, anxiety, etc. The main physiological changes in the perimenopausal period were the fluctuation of sex hormone levels. Hippocampus is a functional region of the brain involved in learning and memory, which plays an important role in the occurrence and development of central neurodegenerative diseases. Magnetic Resonance Spectroscopy (MRS) is a biochemical metabolic analysis in MRI. It is a non-invasive imaging technique for the determination of components and contents of corresponding compounds in living tissues, because the biological changes of tissues often precede morphological changes. Therefore, it has an irreplaceable application value in analyzing and discussing the relationship between different sex hormone levels and cellular metabolites in hippocampal area. Therefore, a comprehensive study of the relationship between serum levels of sex hormones and metabolites in hippocampal tissues is helpful to provide a reliable imaging reference for the differential diagnosis and early diagnosis of diseases related to the hippocampus, such as Alzheimer's disease. Methods: 31 cases of perimenopausal women (perimenopausal group) and 31 healthy young women (healthy young group) were selected. The basic information of age, weight and height were collected. The concentrations of N-acetylaspartate (NAA), total creatine (Cr) and choline (Cho) in the bilateral hippocampus (learning and memory-related regions) of all volunteers were collected by 3.0T magnetic resonance proton spectroscopy. Serum estradiol, luteinizing hormone, follicle stimulating hormone, progesterone and testosterone were measured. The data were statistically analyzed by independent t-test and Pearson correlation. Results: serum estradiol level (P0. 000), serum follicle stimulating hormone level (P0. 012), serum testosterone level (P0. 000), NAA / Cr (P0. 013) in the right hippocampus and NAA / (Cr Cho) in the right hippocampus were significantly decreased (P0. 006). By paired t test, there was a significant difference in NAA / (Cr Cho) between the left and right sides of hippocampus in the perimenopausal group (P0. 010), and in the peri-menopausal group (P0. 004), there was a significant difference between the left and right sides of NAA / (Cr Cho) in the hippocampus of the perimenopausal women. NAA / (Cr Cho) in hippocampus of healthy young women showed significant difference (P0. 012). Pearson correlation analysis showed that NAA / (Cr Cho) in healthy young women had significant difference (P0. 002). Pearson correlation analysis showed that NAA / (Cr Cho) in healthy young women had significant difference (P < 0. 002). The serum estradiol levels in healthy young women were positively correlated with NAA / Cr, NAA / (Cr Cho) in the left hippocampus, NAA / (Cr Cho) in the right hippocampus and NAA / (Cr Cho) in the right hippocampus. There was a negative correlation between serum luteinizing hormone levels and NAA / Cr, Chor / Cr, NAA / (Cr Cho) in left hippocampus, NAA / (Cr Cho) in left hippocampus and NAA / (Cr Cho) in right hippocampus in perimenopausal women (P0. 007, P0. 044, P0. 014, P0. 028), and there was a relationship between serum testosterone and right hippocampal Chor / Cr in perimenopausal women. There was a positive correlation (P0. 027) and a negative correlation (P0. 047) between age and NAA / Cr in the right hippocampus in the perimenopausal group. Conclusion: the higher the serum estradiol level in healthy young women, the higher NAA / Cr Cho / (Cr Cho) in left and right hippocampus, the higher the serum luteinizing hormone level in menopausal women, the lower NAA / Cr Cho in left hippocampus and left side of hippocampus, and the lower in serum estradiol in female. Luteinizing hormone may influence the metabolism of hippocampus through some mechanism.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R741

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