有氧运动对早期阿尔茨海默病患者干预作用的临床研究

发布时间：2018-05-01 06:04

本文选题：阿尔茨海默病 + 有氧运动　；参考：《南京医科大学》2016年硕士论文

【摘要】：目的：通过观察早期阿尔茨海默病(Alzheimer's disease, AD)患者在有氧运动训练前后认知功能、精神行为症状、生活自理能力的改善,评价有氧运动对早期AD患者的干预作用,同时分析事件相关电位N200、P300波幅和潜伏期以及生化指标在训练前后的变化情况,为临床选择合适的AD治疗效果评估工具提供参考。方法;采用随机数字表法将门诊招募的60例阿尔茨海默病患者随机分成30例有氧运动组和30例对照组。运动组给予每周三次,每次40分钟,持续三个月的有氧运动训练。有氧运动为江苏省人民医院康复科编制的一套有氧运动操,经过检测其强度符合中等强度,即运动训练过程中的心率达到最大心率的70%。三个月训练结束后以及六个月随访过程中分别对有氧运动组及对照组进行认知量表评估、生化检查和事件相关电位的检查。认知量表评估主要包括简易精神状态量表(Minimum Mental State Examination, MMSE),阿尔茨海默病认知功能评估量表(Alzheimer's Disease Assessment Scale-cognition, ADAS-cog),阿尔茨海默病日常生活能力评估量表(Alzheimer's Disease Cooperative Study-Activities of Daily Living, ADCS-ADL),神经精神科量表(the Neuropsychiatric Inventory, NPI),阿尔茨海默病生活质量量表(Quality of Life in Alzheimer's Disease, Qol-AD)。生化检查包括胆固醇、甘油三酯、高密度脂蛋白以及低密度脂蛋白。事件相关电位检查主要包括P300和N200的潜伏期、波幅(基峰值和峰峰值)。结果：有氧运动训练前,运动组和对照组在年龄、性别、受教育程度和MMSE分值上均无明显差异。在认知量表评估方面：三个月训练后,运动组MMSE, ADCS-ADL分值均较基线明显增高(P0.05),但和六个月的评估相比没有差异；三个月训练后,ADAS-cog, NPI分值较基线明显降低(P0.05),和六个月的评估相比也没有差异；Qol-AD分值在三个月训练后、六个月随访与基线比较均无明显差异；相关性分析显示运动组ADAS-cog分值变化与ADCS-ADL分值变化呈负相关,对照组MMSE, ADAS-cog, ADCS-ADL, NPI, Qol-AD分值在训练后、随访与基线相比均无明显差异。在生化指标方面：运动组与对照组在训练后、随访与基线相比TC、TG、HDL, LDL值均无明显差异。在事件相关电位方面：运动组P300潜伏期在三个月训练后和六个月随访均较基线有明显降低(P0.05),六个月的随访与三个月相比也有明显降低(P0.05),P300基峰值在三个月和六个月之后均较基线有明显增高(P0.05),三个月和六个月比较未见明显差异,峰峰值在六个月与基线比较有明显增高(P0.05)；对照组P300潜伏期在三个月与基线比较无明显差异,在六个月与基线比较有明显增高(P0.05),基峰值和峰峰值在三个月和六个月与基线比较均无明显差异。运动组N200潜伏期在三个月训练后和基线比较无明显差异,在六个月随访和基线比较明显增高(P0.05),基峰值、峰峰值在三个月和六个月随访与基线比较无明显差异,对照组潜伏期、基峰值和峰峰值在三个月和六个月随访均较基线均无明显差异。结论：表明有氧运动对早期AD患者的认知功能、精神行为症状以及生活自理能力均有改善作用。P300潜伏期可以作为评价AD患者治疗效果的参考指标。
[Abstract]:Objective: To evaluate the effect of aerobic exercise on early AD patients by observing the cognitive function, mental behavior symptoms and self-care ability of early Alzheimer's disease (AD) before and after the training of aerobic exercise, and to evaluate the activity of N200, P300 amplitude and latency and biochemical index in training. The changes were provided for the clinical selection of a suitable AD therapeutic evaluation tool. Methods 60 patients with Alzheimer's disease were randomly divided into 30 aerobic exercise groups and 30 control groups. The exercise group was given 40 minutes a week, aerobic exercise for three months, and aerobic exercise. The exercise is a set of aerobic exercises for the rehabilitation department of Jiangsu Province People's Hospital. After three months of training at the middle intensity of the exercise training, the heart rate reaches the maximum heart rate of three months, and during the six month follow-up process, the aerobic exercise group and the control group are evaluated by the cognitive scale, biochemical examination and the control group, respectively. The assessment of the event related potential. The assessment of the cognitive scale included the simple mental state scale (Minimum Mental State Examination, MMSE), the cognitive function assessment scale of Alzheimer's disease (Alzheimer's Disease Assessment Scale-cognition, ADAS-cog), the assessment of the daily living ability of Alzheimer's disease (Alzheimer's Disease) Ative Study-Activities of Daily Living, ADCS-ADL), neuropsychiatric scale (the Neuropsychiatric Inventory, NPI), Alzheimer's disease quality of life scale (Quality of). Biochemical tests include cholesterol, glycerol three ester, high density lipoprotein, and low density lipoprotein. Event related potential test The investigation included the incubation period of P300 and N200, amplitude (peak value and peak peak). Results: there was no significant difference in age, sex, education and MMSE scores between the exercise group and the control group before the aerobic exercise training. In the cognitive scale evaluation, after three months of training, the scores of MMSE and ADCS-ADL were significantly higher than those of the baseline (P0.05). But there was no difference compared with the six month evaluation; after three months of training, ADAS-cog, NPI scores were significantly lower than the baseline (P0.05), and there was no difference compared with the six month evaluation. The Qol-AD score was no significant difference between the six month follow-up and the baseline after three months of training; the correlation analysis showed that the ADAS-cog score of the sports group was changed with ADCS. The change of -ADL score was negative correlation, and the score of MMSE, ADAS-cog, ADCS-ADL, NPI, Qol-AD in the control group had no significant difference compared with the baseline after training. In biochemical indexes, there was no significant difference in TC, TG, HDL, LDL values between the exercise group and the control group after the training and compared with the baseline. In the event related potential, the exercise group was P300 latency. The period after three months of training and six months follow-up were significantly lower than the baseline (P0.05). The follow-up of six months was significantly lower than that of three months (P0.05). The peak value of the P300 base was significantly higher than the baseline after three months and six months (P0.05), and there was no significant difference between three months and six months. The peak peak value was compared with the baseline for six months. There was a significant increase (P0.05). The P300 latency of the control group was not significantly different from the baseline in three months, and there was a significant increase in the baseline and baseline (P0.05) in the six months. The base peak and peak peak value were not significantly different from the baseline in three months and six months. The N200 latency of the exercise group had no significant difference between the three months after training and the baseline, in six The follow-up and baseline were significantly higher (P0.05). The base peak and peak peak value were not significantly different from the baseline in three months and six months. The latency of the control group, the base peak and peak peak value were no significant difference compared with the baseline at three months and six months. Conclusion: the cognitive function of aerobic exercise to early AD patients was shown to be spiritual. The.P300 latency can be used as a reference index for evaluating the therapeutic effect of AD patients.

【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.16

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