本文選題：腦白質疏松 + 葉酸�。� 參考：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：探討葉酸、維生素B12減低和同型半胱氨酸(Homocysteine，HCY)升高對腦白質疏松癥(Leukoaraiosis,LA)影響和不同嚴重程度腦白質疏松患者葉酸、維生素B12和同型半胱氨酸水平變化趨勢。研究腦白質疏松形成的相關因素。 方法：選取2013年4月-2014年1月期間以頭暈頭昏為主訴且無神經(jīng)系統(tǒng)陽性體征于大連醫(yī)科大學附屬第一醫(yī)院神經(jīng)內科住院部就診患者72例，年齡集中在65歲至89歲之間。所選取72例患者均行頭磁共振成像(Magnetic resonanceimaging,MRI)檢查。其中發(fā)現(xiàn)僅有腦白質疏松的患者36例，將其作為病例組；無腦白質疏松的患者36例，，將其作為對照組。根據(jù)腦白質疏松國際分級標準Kinkel分級法，將腦白質疏松組(LA組)患者分為腦白質疏松1級(LA1)、腦白質疏松2級(LA2)、腦白質疏松3級(LA3)和腦白質疏松4級(LA4)四個組。同時檢測所有患者血清葉酸、維生素B12和同型半胱氨酸濃度。并且收集所選取患者臨床資料，包括性別、年齡、有無高血壓病史、有無糖尿病病史、有無冠心病病史、有無吸煙史、有無飲酒史、有無腔隙性腦梗死。運用t檢驗或秩和檢驗比較LA組和對照組組、LA2組和LA1組之間血清葉酸、維生素B12和同型半胱氨酸水平。運用卡方檢驗和二項logistic回歸分析，研究影響腦白質疏松形成的相關因素。 結果：在對LA組和對照組之間運用卡方檢驗對性別、年齡進行檢驗，各組間結果均無統(tǒng)計學差異(P0.05)。而在LA組和對照組、LA2組和LA1組間運用t檢驗對血清葉酸、維生素B12和同型半胱氨酸水平進行檢驗，差異均有統(tǒng)計學意義(P0.05)。運用卡方檢驗顯示，高血壓、腔隙性腦梗死和吸煙在LA組和對照組之間的差異有統(tǒng)計學意義(P0.05)，其它因素如糖尿病、冠心病和飲酒在兩組之間差異無統(tǒng)計學意義(P0.05)。對高血壓、腔隙性腦梗死和吸煙三個因素進行二項logistic回歸分析比較，發(fā)現(xiàn)高血壓、腔隙性腦梗死和吸煙為腦白質疏松的危險因素。 結論：1.腦白質疏松的發(fā)生與血清葉酸、維生素B12水平減低，血清同型半胱氨酸水平升高密切相關。且隨著葉酸、維生素B12水平越低及血清同型半胱氨酸水平越高，與腦白質疏松嚴重程度越重相關。 2.高血壓、腔隙性腦梗死和吸煙與腦白質疏松發(fā)生相關，且為腦白質疏松發(fā)生發(fā)展的危險因素。糖尿病、冠心病和飲酒與腦白質疏松發(fā)生無相關性。
[Abstract]:Objective: to investigate the effects of folic acid, vitamin B12 reduction and homocysteine (HCY) on leukoaraiosis (LeukoaraiosisLA) and the changes of folic acid, vitamin B12 and homocysteine levels in patients with different severity of leukoaraiosis. To study the factors related to the formation of leukoaraiosis. Methods: from April 2013 to January 2014, 72 patients with dizziness and dizziness were selected from the Department of Neurology, Department of Neurology, first affiliated Hospital of Dalian Medical University, aged 65 to 89 years. Magnetic resonance imaging (MRI) was performed in 72 patients. 36 cases of leukoaraiosis were found as case group and 36 cases of anencephaly as control group. According to Kinkel classification method, the patients in the leukoaraiosis group (LA group) were divided into four groups: leukoaraiosis grade 1 (LA1), leukoaraiosis grade 2 (LA2), leukoaraiosis grade 3 (LA3) and leukoaraiosis grade 4 (LA4). Serum folic acid, vitamin B 12 and homocysteine concentrations were also measured in all patients. The clinical data including sex, age, hypertension history, diabetes history, coronary heart disease history, smoking history, drinking history and lacunar cerebral infarction were collected. Serum folic acid, vitamin B12 and homocysteine levels were compared between LA group and control group by t test or rank sum test. By using chi-square test and binomial logistic regression analysis, the factors related to the formation of leukoaraiosis were studied. Results: chi-square test was used to test gender and age between LA group and control group. There was no statistical difference between the two groups (P0.05). The serum levels of folic acid, vitamin B12 and homocysteine were detected by t test in LA group and control group (P0.05). Chi-square test showed that there was significant difference between LA group and control group in hypertension, lacunar cerebral infarction and smoking (P0.05), while other factors such as diabetes, coronary heart disease and alcohol consumption had no significant difference between the two groups (P0.05). Three factors, hypertension, lacunar cerebral infarction and smoking, were analyzed by binary logistic regression analysis. It was found that hypertension, lacunar infarction and smoking were risk factors of leukoaraiosis. Conclusion 1. The occurrence of leukoaraiosis was closely related to the decrease of serum folic acid and vitamin B12 levels and the increase of serum homocysteine level. With folic acid, the lower the level of vitamin B12 and the higher the level of serum homocysteine, the more serious the severity of leukoaraiosis. Hypertension, lacunar infarction and smoking were associated with leukoaraiosis and were risk factors for the development of leukoaraiosis. Diabetes, coronary heart disease and alcohol consumption were not associated with leukoaraiosis.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R742

【參考文獻】

相關期刊論文 前6條

1 王松海;;腦白質疏松癥的CTMRI征象及臨床特征[J];安徽醫(yī)學;2013年10期

2 劉險峰;張國華;;缺血性腦白質疏松癥患者血漿同型半胱氨酸、血清葉酸及維生素B_(12)水平的變化[J];解放軍醫(yī)學雜志;2007年05期

3 孫建仙;劉小立;;神經(jīng)酰胺的代謝及其在細胞凋亡中的作用[J];科技信息;2008年33期

4 于挺敏,滿玉紅,李自如;腦白質缺血性損傷與維生素B_(12)[J];中國臨床康復;2005年25期

5 于挺敏,張春英,滿玉紅,李自如,姜虹;甲基維生素B_(12)對擬血管性癡呆大鼠記憶功能及腦白質病理變化的影響[J];中風與神經(jīng)疾病雜志;2005年04期

6 張春英;于挺敏;;葉酸,維生素B_(12)與缺血性腦血管病[J];中國社區(qū)醫(yī)師(綜合版);2004年13期

本文編號：2061030