生命早期经历营养不良人群认知功能初步调查

发布时间：2018-03-30 10:19

本文选题：早期营养不良　切入点：健康和疾病的发育起源　出处：《重庆医科大学》2014年硕士论文

【摘要】：背景阿尔茨海默病(Alzheimer’s disease,AD)的发病率及死亡率不断增高，而如今中国正逐步向老龄化社会转化，如何早期发现、诊断并治疗AD，提高老年人的生活质量，，降低致死、致残率，将是社会关注的重点。越来越多的研究证实健康和疾病的发育起源理论的合理性。一些研究也表明早期营养不良和子代后期认知功能障碍密切相关。经历我国历史上的三年自然灾害(1959-1961)时期的人群，普遍暴露于生命早期营养不良，故对其认知功能的调查，有助于明确早期营养不良对认知功能产生的影响。目的研究生命早期经历营养不良，即暴露于中国三年自然灾害（1959-1961）人群的认知功能水平，并讨论影响认知功能的可能因素。方法选取2013年10月到2014年3月在重庆医科大学附属第一医院体检中心进行体检并自愿接受调查的人为研究对象。定义出生在1960.1.1—1961.12.31时期的为胎儿期经历营养不良组（G2组）。定义之前（1957.1.1—1958.12.31）出生的为婴幼儿期经历营养不良组（G1组），及之后（1963.1.1—1964.12.31）出生的为未经历营养不良组（G3组）。需排除任何可以导致脑功能紊乱的躯体和精神疾病，对符合条件的调查对象进行问卷调查、量表测定，并收集其常规实验项目。采用SPSS17.0进行统计学分析，采用卡方检验、单因素方差分析或秩和检验进行组间分析，各种因素对认知功能的影响因素采用多因素Logistic回归模型分析。结果（1）按经历营养不良时间分组，G1组的认知功能评分为MMSE28.68±1.06、MoCA26.79±1.17，G2组的认知功能评分为MMSE28.53±1.27、MoCA26.47±1.25， G3组的认知功能评分为MMSE29.23±0.89、MoCA27.44±1.09，三组间的MMSE得分P值为0.002，MoCA得分P值为0.000，差异均有统计学意义；（2）按认知功能评分分组，多因素logistic回归分析结果：胎儿时期经历营养不良环境、高LDL水平、吸烟史、性格内向、不善于学习思考是影响认知功能的重要因素。结论生命早期不同时期暴露于营养不良环境中，均可能会损害认知功能，且胎儿时期经历早期营养不良其认知功能损害更明显。降低LDL水平、不吸烟、养成乐观向上的性格及培养良好的思考学习习惯，可能为胎儿期经历早期营养不良的个体预防出现认知功能障碍的方法。
[Abstract]:The background of Alzheimer's disease (Alzheimer 's disease, AD) morbidity and mortality increased, and now Chinese are gradually aging society transformation, how to early detection, diagnosis and treatment of AD, improve the quality of life of the elderly, reduce the mortality and disability rate, will be the focus of social attention. More and more studies have confirmed that the theory of rationality of developmental origins of health and disease. Some studies have shown that early is closely related to malnutrition and offspring later cognitive dysfunction. Experience in the history of our country three years of natural disasters (1959-1961) during the period of the crowd, generally exposed to malnutrition early in life, so on the cognitive function of the investigation, influence to help clear early malnutrition on cognitive function of generation.
Objective to study the cognitive function level of early life malnutrition, which is exposed to three years' natural disasters in China (1959-1961), and discuss the possible factors that influence cognitive function.
Methods from October 2013 to March 2014 as the research object of medical examination at the First Affiliated Hospital of Chongqing Medical University medical center and a voluntary survey. The definition was born in 1960.1.1 - 1961.12.31 during the fetal period experienced malnutrition group (group G2). Before the definition (1957.1.1 - 1958.12.31) for infants born experience malnutrition group (group G1), and after (1963.1.1 - 1964.12.31) was born to experience malnutrition group (group G3). To exclude any brain disorders can lead to physical and mental diseases, conducted a questionnaire survey to investigation object to meet the conditions, scale determination, and collect the conventional experimental project. Using SPSS17.0 for statistical analysis, chi square test, single ANOVA or rank sum test between group analysis, factors of various influencing factors on cognitive function by multi factor Logistic regression model analysis.
Results (1) according to the experience of malnutrition time group, cognitive function score of group G1 is MMSE28.68 + 1.06, MoCA26.79 + 1.17, cognitive function score of group G2 is MMSE28.53 + 1.27, MoCA26.47 + 1.25, cognitive function score of group G3 is MMSE29.23 + 0.89, MoCA27.44 + 1.09, between the three groups of MMSE score P 0.002, the MoCA score of P was 0, there were statistically significant differences; (2) according to the score of cognitive function group, logistic regression analysis results: the fetal period of malnutrition, high LDL levels, smoking history, introverted, not good at thinking and learning are important factors affecting cognitive function.
Conclusion early life in different periods of exposure to poor nutrition environment, may have cognitive function damage, and the fetal period experienced early malnutrition, the cognitive impairment is more obvious. Decrease the level of LDL, not smoking, learning habits to cultivate optimistic personality and develop good thinking, may experience early malnutrition individual prevention methods cognitive impairment for the fetal period.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.1

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