老年男性血管性痴呆患者药物干预前后雌激素水平和认知功能的研究

发布时间：2018-04-13 09:46

本文选题：血管性痴呆 + 血清雌二醇　；参考：《新乡医学院》2013年硕士论文

【摘要】：背景血管性痴呆一组由各种脑血管病所引起认知损害为主的综合征,病因复杂,危害严重,早期可防治。目前关于雌激素对认知功能的作用,研究结果不一致。石杉碱甲是一种可逆性胆碱酯酶抑制剂,通过多种途径提高脑内的乙酰胆碱的水平和功能,研究发现乙酰胆碱的变化对体内性腺轴产生一定影响,关于石杉碱甲是否影响血管性痴呆患者雌二醇(estradiol, E2)水平国内外无相关的研究报道。目的 1、探讨老年男性血管性痴呆患者血清雌二醇水平。 2、探讨老年男性血管性痴呆患者血清E2水平与认知功能的关系。 3、探讨石杉碱甲对老年男性血管性痴呆患者认知功能及血清E2水平的影响。方法 1、选择98例符合NINDS-AIREN诊断标准的血管性痴呆患者(VD组)作为研究对象,用年龄与研究组匹配的无认知障碍脑血管病患者(脑血管病组)60例及健康老年人60例(正常组)作为对照。 2、VD组随机分为VD研究组和VD对照组,各49例,VD研究组在基础治疗基础上加服石杉碱甲(150μg,每日两次),连续服用3个月；VD对照组只给予基础治疗3个月。 3、使用简易精神状态量表(Mini-Mental State Examination, MMSE)和维迪Keypiont4通道诱发电位仪测定各研究对象治疗前以及治疗3个月后MMSE得分、事件相关电位P300(event-related potentials P300, ERP-P300)(?)勺潜伏期及波幅。 4、利用全自动电化学发光免疫分析系统测定各组治疗前及VD组治疗3个月后血清E2水平。 5、所有数据均经SPSS16.0统计软件包进行处理。用x2检验比较各组间文化程度差异；用F检验比较VD组、脑血管病组、正常组E2水平、MMSE得分、P300潜伏期及波幅的差异；用t检验比较VD组E2水平、MMSE得分、P300潜伏期及波幅差异,用Pearson相关分析法分析VD组治疗前、后E2水平、MMSE得分、P300潜伏期及波幅各测量值间的相互关系。所有检验均为双侧检验,以P0.05为差异有显著意义。结果 1、VD组血清E2水平高于脑血管病组及正常组(F=64.170,P=0.000)；脑血管病组血清E2水平高于正常组(P0.01)。 2、VD组P300潜伏期较脑血管病组及正常组延长(F=92.944,P=0.000)：VD组P300波幅低于脑血管病组及正常组(F=47.766,P=0.000)。与正常组相比,脑血管病组P300潜伏期延长(P0.01),P300波幅降低(P0.05),差异有统计学意义。 3、相关分析显示：VD组血清E2水平与MMSE得分呈负相关(r=—0.432,P=0.000),与P300潜伏期呈正关联(r=0.334,P=0.001),与P300波幅无关联(r=—0.194,P=0.055)：MMSE得分与P300潜伏期呈负相关(r=—0.309,P=0.002)。 4、治疗3个月后,VD研究组MMSE得分较治疗前升高(t=3.337,P=0.001),也较VD对照组高(t=3.736,P=0.000)；VD研究组P300潜伏期较治疗前缩短(t=2.653,P=0.010),也较VD对照组短(t=2.098,P=0.038)；VD研究组P300波幅治疗前后无统计学意义(P0.05),与VD对照组相比也无统计学意义(P0.05)；VD对照组MMSE、P300潜伏期及波幅较3个月前相比均无统计学意义(P0.05)。 5、治疗3个月后,VD研究组血清E2水平无明显变化(t=1.495,P=0.140),VD对照组血清E2水平也无明显变化(t=0.542,P=0.590)。 6、VD研究组治疗后相关分析显示：VD研究组血清E2水平差值与MMSE得分差值、P300潜伏期差值及波幅差值均无关联(r=—0.119、0.160、0.227,P=0.417、0.273、0.117)：MMSE得分差值与P300潜伏期差值呈负相关(r=—0.357,P=0.012)。结论 1、老年男性血管性痴呆患者血清E2水平较非认知障碍脑血管病患者和健康老年人明显升高,高水平的E2可能对老年男性血管性痴呆患者认知功能具有一定的不良影响。 2、石杉碱甲对改善老年男性血管性痴呆患者的认知功能有一定的意义,对老年男性血管性痴呆患者血清E2水平无明显影响。
[Abstract]:background
The syndrome of vascular dementia by a group of various cerebrovascular disease caused by cognitive impairment mainly causes complex, serious harm, early prevention. The effects of estrogen on the cognitive function, the results are not consistent. Huperzine A is a reversible acetylcholinesterase inhibitor, improve the level and function of brain acetylcholine through a variety of ways, the study found that acetylcholine changes have a certain impact on the in vivo gonadal axis of huperzine A is affected in patients with vascular dementia estradiol (estradiol, E2) - related research reports at home and abroad.
objective
1, to investigate the level of serum estradiol in senile male patients with vascular dementia.
2, to investigate the relationship between the level of serum E2 and cognitive function in elderly male patients with vascular dementia.
3, the effect of huperzine A on cognitive function and serum E2 level in elderly male patients with vascular dementia was investigated.
Method
1, 98 patients with vascular dementia (group VD) who met the diagnostic criteria of NINDS-AIREN were selected as the subjects. 60 patients without cerebrovascular disease (cerebrovascular disease) matched with the study group and 60 healthy elderly patients (normal group) were used as controls.
2, VD group was randomly divided into VD research group and VD control group, 49 cases in each group. The VD research group added huperzine A (150 g, two times a day) on the basis of basic treatment, and continued to take 3 months. VD control group only received basic treatment for 3 months.
3, using the Mini Mental State Scale (Mini-Mental State Examination, MMSE) and "Keypiont4 channel determination of evoked potential instrument subjects before treatment and 3 months after treatment MMSE score, event-related potential P300 (event-related potentials P300, ERP-P300) (?) the latency and amplitude.
4, the serum levels of E2 were measured by the automatic electrochemiluminescence immunoassay system before and after treatment in group VD for 3 months.
5, all the data were processed by SPSS16.0 statistical software package. Using x2 test to compare the group differences between cultures; VD were compared with F test, cerebrovascular disease group and normal group E2 level, MMSE score, the difference in P300 latency and amplitude; compare the level of E2 in group VD was tested with T, MMSE, P300 the latency and amplitude difference analysis using Pearson correlation analysis method of VD group before treatment, E2 level, MMSE score, P300 latency and amplitude of the measured value of the relation. All tests were two-sided test, P0.05 showed significant difference.
Result
1, the level of serum E2 in the group VD was higher than that of the cerebrovascular disease group and the normal group (F=64.170, P=0.000), and the serum E2 level of the cerebrovascular disease group was higher than that of the normal group (P0.01).
2, VD group P300 latency cerebrovascular disease group and normal group (F=92.944, P=0.000) extended:VD group P300 were below the cerebrovascular disease group and normal group (F=47.766, P=0.000). Compared with the normal group, the cerebrovascular disease group (P0.01), P300 latency and amplitude of P300 decreased (P0.05), there was statistical significance the difference.
3, correlation analysis showed that the serum E2 level in VD group was negatively correlated with MMSE score (r= - 0.432, P=0.000), positively correlated with P300 latency (r=0.334, P=0.001), and was not correlated with P300 amplitude (r= - 0.194, P=0.055). There was a negative correlation between the score of incubation and latent period of incubation (0.309 - 0.309).
4, after 3 months of treatment, VD MMSE scores of study group were increased compared with before treatment (t=3.337, P=0.001), compared with VD control group (t=3.736, P=0.000); VD group P300 latency reduced than those before treatment (t=2.653, P=0.010), compared with VD control group (t=2.098, P=0.038); VD. The group P300 was statistical significance before and after treatment (P0.05), compared with the VD control group had no statistical significance (P0.05); VD control group MMSE, P300 latency and amplitude is compared to 3 months ago had no statistical significance (P0.05).
5, after 3 months of treatment, there was no significant change in serum E2 level in VD study group (t=1.495, P=0.140), and there was no significant change in serum E2 level in VD control group (t=0.542, P=0.590).
6, according to VD correlation analysis of the study group after treatment VD group, serum E2 level and MMSE score difference, P300 latency and amplitude difference values are not related (r= 0.119,0.160,0.227, P=0.417,0.273,0.117):MMSE score was negatively correlated with P300 latency difference (r= 0.357, P=0.012).
conclusion
1, serum E2 level in elderly male patients with vascular dementia is significantly higher than that in non cognitive impairment, cerebrovascular disease and healthy elderly. High level of E2 may have some adverse effects on cognitive function in elderly men with vascular dementia.
2, huperzine A has a certain significance in improving cognitive function in elderly men with vascular dementia, but has no significant effect on serum E2 level in elderly men with vascular dementia.

【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.16

【参考文献】