不同程度阿尔茨海默病与甲状腺激素、血脂关系的研究

发布时间：2018-04-11 13:09

本文选题：阿尔茨海默病 + 痴呆　；参考：《浙江大学》2012年硕士论文

【摘要】：目的：通过检测阿尔茨海默病(AD)患者血清甲状腺激素和血脂系列水平变化,探讨甲状腺激素和血脂在AD发病中的作用和意义,为预防和治疗AD提供实验依据。方法：1.病例收集和标本采集：随机收集AD患者103例(轻度32例、中度44例、重度27例),均为2008年10月-2010年9月嘉兴市康慈医院门诊和住院患者。入选标准：①AD组：所有患者符合美国精神病协会《精神障碍诊断和统计手册》第四版(DSM—IV)制定的AD诊断标准, Hachinski缺血指数(HIS)4分。正常对照(NC)组：31例,为健康志愿者及健康体检者,年龄匹配、无智能障碍、无神经精神科疾病史、无内分泌疾病史及痴呆家族史。所有研究对象均进行MMSE、HIS量表检测,AD组患者使用临床痴呆评定量表(CDR)评定痴呆程度为轻、中、重度。采集早晨6时空腹静脉血5ml,不抗凝,血样静置,标本送嘉兴市康慈医院检验科。2.指标测定：对AD患者和健康志愿者的促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)以及胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)分别测定,并进行统计学分析。结果：1.下丘脑-垂体-甲状腺(HPT)轴血清相关激素的变化：与NC组比较,AD组T3和FT3的水平明显降低(2.17±0.43ng/ml Vs1.59±0.50ng/ml；4.98±0.67pg/ml Vs3.95±0.81pg/ml),差异具有显著统计学意义(P0.01)；而T4和FT4的水平两组比较差异无显著性(P0.05)。多元线性回归分析结果显示,血清T3水平与CDR评分存在负相关性(P0.05),即随着CDR评分的增高,血清T3水平呈下降趋势。2.血脂系列的变化：与NC组比较,AD组HDL和ApoA水平明显降低(2.12±0.38mmol/1Vs1.52±0.39mmol/1;1.65±0.12mmol/l Vs1.43±0.30mmol/1),差异具有显著统计学意义(P0.01)；AD组LDL较NC组明显升高(2.12±0.38mmol/1Vs2.96±1.17mmol/1),差异有显著统计学意义(P0.01),AD组内比较差异无显著性意义(P0.05)。而TC、TG和ApoB的水平两组比较差异无显著性(P0.05),AD组内比较差异无显著性意义(P0.05)。结论：1.AD患者HPT轴血清相关激素中T3和FT3水平明显降低,并且T3的下降与AD的严重程度相关。提示AD的发生与T3、FT3等内分泌因素密切相关,T3、FT3是AD的危险因素,针对内分泌因素的预防和治疗可能有利于降低AD的发病风险,改善患者的预后,提高患者的生活质量。2.AD患者存在HDL和ApoA水平的明显降低以及LDL的明显升高。提示血脂代谢可能和痴呆发病有关,调脂治疗可能有助于AD的防治。
[Abstract]:Objective: to investigate the role and significance of thyroid hormone and lipid in the pathogenesis of AD by detecting the changes of serum thyroid hormone and lipid series in patients with Alzheimer's disease (AD), and to provide experimental evidence for the prevention and treatment of AD.Method 1: 1.Case collection and specimen collection: 103 AD patients (32 mild, 44 moderate and 27 severe) were collected randomly from October 2008 to September 2010.Admission criteria: one AD group: all patients met the AD diagnostic criteria developed by the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders, Hachinski Ischemia Index (HIS) 4.The normal control group (n = 31) consisted of 31 healthy volunteers and healthy persons with age matching, no mental disorders, no history of neuropsychiatric diseases, no history of endocrine diseases and family history of dementia.All subjects were assessed with MMSE his scale for mild, moderate and severe dementia in AD group using clinical dementia rating scale (CDR).Collect 5 ml fasting venous blood at 6 am, no anticoagulant, blood sample static, samples sent to Department of Laboratory of Kangci Hospital, Jiaxing City.The levels of HDL, LDLN, ApoAn, ApoB, ApoB, ApoB, ApoB, ApoB, ApoB, ApoB, ApoB, ApoB, ApoB were measured.Statistical analysis was carried out.The result is 1: 1.The results of multiple linear regression analysis showed that there was a negative correlation between serum T3 level and CDR score (P 0.05), that is, with the increase of CDR score, serum T3 level showed a decreasing trend.There was no significant difference in TG and ApoB levels between the two groups.Conclusion: 1. The levels of T3 and FT3 in serum of AD patients were significantly lower than those of patients with AD, and the decrease of T3 was related to the severity of AD.It is suggested that the occurrence of AD is closely related to endocrine factors such as T _ 3T _ 3T _ 3 and T _ 3T _ 3T _ 3 is a risk factor of AD. The prevention and treatment of endocrine factors may help to reduce the risk of AD and improve the prognosis of AD patients.Improve the quality of life of patients. 2. The patients with AD had significantly lower levels of HDL and ApoA and increased LDL.The results suggest that lipid metabolism may be related to the onset of dementia, and lipid regulation therapy may be helpful to the prevention and treatment of AD.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16

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