60例认知功能障碍患者危险因素的相关研究

发布时间：2018-04-16 11:13

本文选题：认知功能障碍 + 阿尔茨海默病　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:回顾性分析2014年1月至2017年1月年吉林大学某医院收治的认知功能障碍患者并进行调查,分析认知功能障碍相关的危险因素,并推测海马萎缩与认知功能障碍发生及发展的相关性,为认知功能障碍的早期发现及早期干预提供线索。方法:收集2014年1月至2017年1月吉林大学某医院收治的认知功能障碍患者并进行分析,筛选出明确诊断为认知功能障碍患者,共计60例,其中痴呆组46例,轻度认知功能障碍组14例,同时采集患者的民族、性别、年龄、血压(收缩压)、空腹血糖、甘油三酯、低密度脂蛋白胆固醇、总胆固醇、高密度脂蛋白胆固醇、颈动脉血管彩超、海马萎缩程度(3.0T头部核磁)等资料,采集患者MMSE及MOCA量表各个子项目的分值,收集我科同期住院认知功能正常患者60例作为对照组,并收集上述相关项目及所有临床数据资料。所得数据均采用SPSS22.0统计软件进行分析,计量资料采用t检验,计数资料采用X2检验,指标间关系连续变量采用PEARSON分析,分级变量采用SPEARMAN分析,危险因素采用Logistic回归分析,P0.05为差异有统计学意义。结果:1.痴呆组、轻度认知功能障碍组、对照组患者年龄、性别差异无统计学意义,三组患者受教育程度程度经检验MCI组受教育程度高于痴呆组,对照组受教育程度高于MCI组,P=0.000,有统计学意义。2.本研究中的患者海马均有一定程度的萎缩,且海马萎缩MTA分级与患者年龄呈正相关,即年龄越高,MTA分级越高;与MOCA得分呈负相关,即海马萎缩越重,相应的MOCA得分越低;与CDR得分呈正相关,即海马萎缩越重,痴呆程度也越重,与血同型半胱氨酸及颈动脉硬化程度也呈现正相关。3.总体患者中各因素与MMSE/MOCA得分经相关性分析结果显示MMSE得分与受教育程度呈正相关,MOCA得分与受教育程度呈正相关,与高密度脂蛋白胆固醇水平呈正相关。4.认知功能障碍组与糖尿病病史存在相关性,认知功能障碍组空腹血糖(P=0.023)、低密度脂蛋白胆固醇(P=0.046)、血同型半胱氨酸(P=0.001)及颈动脉硬化程度(P=0.019)高于非认知功能障碍组,有显著统计学意义。5.多因素Logistic回归分析显示低密度脂蛋白胆固醇、血同型半胱氨酸、海马萎缩MTA分级2级(伴脑室颞角扩大)为认知障碍的独立危险因素,P0.05有统计学意义。结论:1.认知功能障碍患者MOCA得分与受教育程度存在正相关,表示较高的受教育程度是认知功能障碍的保护性因素。2.海马萎缩程度与年龄正相关,与血同型半胱氨酸、颈部动脉硬化程度存在正相关。3.认知功能障碍与空腹血糖、是否伴有糖尿病病史、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血同型半胱氨酸、颈部动脉硬化程度、海马萎缩MTA分级存在相关性。4.低密度脂蛋白、血同型半胱氨酸、伴有颞角扩大的海马萎缩为认知功能障碍的独立危险因素。
[Abstract]:Objective: to retrospectively analyze and investigate the patients with cognitive dysfunction in a hospital of Jilin University from January 2014 to January 2017, and analyze the risk factors related to cognitive dysfunction.The correlation between hippocampal atrophy and the occurrence and development of cognitive dysfunction provides clues for early detection and early intervention of cognitive dysfunction.Methods: from January 2014 to January 2017, 60 patients with cognitive dysfunction were selected and analyzed in a hospital of Jilin University, including 46 patients with dementia.In the mild cognitive impairment group of 14 patients, the nationality, sex, age, blood pressure (systolic blood pressure, fasting blood glucose, triglyceride, low density lipoprotein cholesterol, total cholesterol, high density lipoprotein cholesterol) were collected.Carotid artery color Doppler ultrasound, hippocampal atrophy degree and 3.0T head nuclear magnetic field were used to collect the scores of the subitems of MMSE and MOCA, and 60 patients with normal cognitive function were collected as the control group.And collect the above related items and all clinical data.The data were analyzed by SPSS22.0 statistical software, the measurement data were analyzed by t test, the count data by X2 test, the continuous variables of the relationship between indexes were analyzed by PEARSON, and the graded variables were analyzed by SPEARMAN.The risk factors were significantly different by Logistic regression analysis (P 0.05).The result is 1: 1.There was no significant difference in age and sex among dementia group, mild cognitive impairment group and control group. The educational level of the three groups was higher than that of the dementia group, and the educational level of the three groups was higher than that of the dementia group.The educational level of the control group was higher than that of the MCI group.The MTA grade of hippocampal atrophy was positively correlated with the patient's age, that is, the higher the age, the higher the score of MOCA, that is, the heavier the hippocampal atrophy, the lower the corresponding MOCA score.There was a positive correlation with CDR score, that is, the more severe the hippocampus atrophy, the more severe the dementia, and the positive correlation with homocysteine and carotid arteriosclerosis.The results of correlation analysis showed that there was a positive correlation between MMSE score and education level and a positive correlation between MMSE score and education level, and a positive correlation between MMSE score and high density lipoprotein cholesterol level.There was a correlation between cognitive dysfunction group and diabetic history. The levels of fasting blood glucose, low density lipoprotein cholesterol (LDL-C), plasma homocysteine (P0. 001) and carotid arteriosclerosis in cognitive dysfunction group were significantly higher than those in non cognitive dysfunction group (P 0. 023, P 0. 046, P 0. 019).There is significant statistical significance.Multivariate Logistic regression analysis showed that low density lipoprotein cholesterol (LDL-C), homocysteine (Hcy) and hippocampal atrophy (MTA grade 2) were independent risk factors for cognitive impairment (P0.05).Conclusion 1.There was a positive correlation between MOCA score and education level in patients with cognitive dysfunction, indicating that higher level of education was the protective factor of cognitive dysfunction.The degree of hippocampal atrophy was positively correlated with age, blood homocysteine and cervical arteriosclerosis.Cognitive dysfunction was correlated with fasting blood glucose, history of diabetes, low density lipoprotein cholesterol, high density lipoprotein cholesterol, homocysteine, degree of atherosclerosis in the neck, and MTA grade of hippocampal atrophy.Low density lipoprotein, homocysteine and hippocampal atrophy with temporal horn enlargement were independent risk factors for cognitive impairment.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.1

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