阿尔茨海默病及遗忘型轻度认知障碍患者血浆sCD40、sCD40L、TNF-α浓度研究

发布时间：2018-06-24 18:14

本文选题：阿尔茨海默病 + 遗忘型轻度认知障碍　；参考：《中山大学》2015年硕士论文

【摘要】：【目的】探索阿尔茨海默病(Alzheimer’s Disease,AD)、遗忘型轻度认知障碍(amnestic Mild Cognitive Impairment,a MCI)血浆s CD40、s CD40L、TNF-α浓度的特点;探索AD、a MCI血浆s CD40、s CD40L、TNF-α浓度与认知功能相关性。【方法】本研究以AD(25例)、a MCI(40例)和健康对照者(42例)为研究对象。应用简易精神状态评定量表(MMSE)、听觉词语学习测验(AVLT)、Boston命名测验、数字广度测验(DST)、画钟测验(CDT)、阿尔茨海默病评定量表-认知部分(ADAS-cog)、总体衰退量表(GDS)、临床痴呆评定量表(CDR)、日常生活能力量表(ADL)、神经精神症状评定量表(NPI)、哈金斯基缺血指数量表(HIS)评定患者认知功能及精神行为症状。采用商品化的ELISA试剂盒(e Bioscience)检测血浆s CD40、s CD40L、TNF-α浓度。【结果】1、血浆s CD40浓度在AD组、a MCI组及健康对照组三组之间差异均无统计学意义(P0.05);血浆s CD40L浓度a MCI组均显著高于AD组、健康对照组(均P0.05),AD组与健康对照组之间差异无统计学意义(P0.05);血浆TNF-α浓度a MCI组显著高于AD组(P0.05),a MCI组和健康对照组之间差异无统计学意义(P0.05),AD组和健康对照组之间差异无统计学意义(P0.05)。2、画钟测验(CDT)得分AD组均显著低于a MCI组和NC组(均P0.001);a MCI组和NC组差异无统计学意义(P0.05)。ADAS-cog总得分、ADAS-cog-记忆因子分AD组显均著高于a MCI组、NC组(均P0.001),a MCI组显著高于NC组(P0.001)。ADAS-cog-语言因子分、ADAS-cog-注意力因子分、ADAS-cog-操作能力因子分、神经精神问卷(NPI)得分AD组均显著高于a MCI组、NC组(均P0.001),a MCI组和NC组间差异无统计学意义(P0.05)。Boston命名测验、数字广度测验倒背和顺背得分a MCI组和NC组差异均无统计学意义(均P0.05)。3、对AD组血浆s CD40、s CD40L、TNF-ɑ浓度与MMSE、ADAS-cog、NPI、DST顺背、DST倒背得分进行相关性分析显示:均无相关性(均P0.05)。对a MCI组血浆s CD40、s CD40L、TNF-ɑ浓度与MMSE、ADAS-cog、NPI、DST顺背、DST倒背、Boston命名测验得分进行相关性分析显示:s CD40L浓度与MMSE得分有显著负相关(P=0.006)。【结论】1、s CD40L可能参与了a MCI的发病过程,s CD40L、TNF-ɑ可能参与了AD免疫功能减弱的过程。2、注意、语言、执行功能等认知功能损害较记忆障碍出现晚,均在AD阶段出现。3、s CD40L可能可以作为反映aMCI患者认知损害严重程度的状态指标。s CD40、s CD40L、TNF-ɑ可能不适合作为作为反映AD患者痴呆严重程度的状态指标。
[Abstract]:[objective] to explore the characteristics of plasma s CD40 and CD40 LT TNF- 伪 levels in patients with Alzheimer's disease (AD) and amnestic cognitive impairment (MCI). To explore the correlation between the plasma levels of sCD40L- 伪 and cognitive function in patients with adriamycin A MCI. [methods] A total of 40 patients with AD (25 cases) and 42 healthy controls (n = 42) were studied in this study. Simple mental state assessment scale (MMSE), auditory word learning test (AVLT) and Boston nomenclature test were used. Digital Span Test (DST), clock drawing Test (CDT), Alzheimer's Disease rating scale-Cognitive part (ADAS-cog), General decline scale (GDS), Clinical dementia rating scale (CDR), ability of Daily living (ADL), Neuropsychiatric symptom scale (NPI), Hazinsky Ischemia The index scale (his) was used to assess the cognitive function and mental behavior of the patients. Using commercial Elisa kit (e Bioscience) to detect the concentration of plasma s CD40 / L TNF- 伪. [results] 1. There was no significant difference in plasma s CD40 concentration between AD group and healthy control group (P0.05), and the plasma s CD40L concentration in aMCI group was significantly higher than that in AD group. There was no significant difference between AD group and healthy control group (P0.05), and the plasma TNF- 伪 concentration in a MCI group was significantly higher than that in AD group (P0.05) and healthy control group (P0.05). (P0.05) there was no significant difference between AD group and healthy control group (P0.05). The score of clock drawing test (CDT) in AD group was significantly lower than that in AMCI group and NC group (P0.001). There was no significant difference between AD group and NC group (P0.05). ADAS-cog- memory factor score in AD group was significantly higher than that in NC group (P0.001). The scores of ADAS-cog-language factor and ADAS-cog-attention factor were significantly higher than those of NC group (P0.001). The scores of neuropsychiatric questionnaire (NPI) in AD group were significantly higher than those in NC group (P0.001), and there was no significant difference between AD group and NC group (P0.05) .Boston nomenclature test. There was no significant difference between the two groups (P0.05). The correlation analysis between the plasma sCD40L ~ + TNF- and the MMSE ADAS-CogN NPII-DST reverse back score showed that there was no correlation between the plasma sCD40L- CD40L- TNF- and MMSEN-ADAS-CogCG-NPII-DST inverse DST scores in AD group (all P 0.05). The results showed that there was no significant difference between the two groups in the scores of reverse back and forward back (P < 0.05). The correlation analysis between the plasma sCD40, sCD40L, TNF-, and the MMSE ADAS-CogGN NPIST DST reverse DST Boston nomenclature test showed that there was a significant negative correlation between the concentration of 10% s CD40L and the MMSE score (P0. 006). [conclusion] 1s CD40L may be involved in the pathogenesis of a MCI, and the CD40L may be involved in the pathogenesis of aMCI. Can participate in AD immune function decline. 2, pay attention, Cognitive impairment such as language and executive function appears later than memory impairment. The occurrence of. 3s CD40L in AD may be a state index to reflect the severity of cognitive impairment in patients with aMCI. S CD40 / TNF- may not be suitable as a state index to reflect the severity of dementia in AD patients.
【学位授予单位】：中山大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R749.16

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