慢性精神分裂症合并糖尿病患者的认知功能研究

发布时间：2018-06-29 15:28

本文选题：慢性精神分裂症合并糖尿病 + 炎性因子　；参考：《青岛大学》2017年硕士论文

【摘要】：目的探究慢性精神分裂症合并糖尿病(Chronic schizophrenia with diabetes mellitus,CSDM)的炎性因子(IL-6、TNF-α、IL-1β)水平与认知功能障碍之间的相关性,以期为临床治疗提供理论指导。方法本研究采取回顾性研究的方式,选取2014年12月~2016年12月在本院收治的60例CSDM患者作为观察组,其中37例为男性患者,23例为女性患者,年龄范围19岁~53岁,平均年龄(38.37±9.77)岁,根据认知测评结果的不同将观察组患者分为观察组A与观察组B,其中观察组A为39例轻度认知障碍患者,观察组B为21例重度认知障碍患者。纳入标准:(1)所有研究对象年龄范围18岁~55岁;(2)所有观察组患者均符合ICD-10精神分裂症诊断标准;(3)所有观察组入选患者均为CSDM患者;(4)患者均为2型糖尿病患者,FBG≥6.1mmol/L或2h PBG≥7.8mmol/L;(5)患者及其家属均知情同意并签署知情同意书,并经本院伦理委员会批准。排除标准:(1)患有全身性疾病;(2)患者存在心肝肾等主要脏器病变;(3)患者有家族精神病史或精神病史;(4)患者为哺乳期或处于特殊生理时期妇女;(5)患者有过敏史或曾经接受过免疫抑制剂治疗。另选同期在本院进行入院体检的精神状况正常的志愿者40例(即无精神病史且也无家族精神病史)作为对照组,其中男性27例,女性13例,年龄18岁~54岁,平均年龄(38.64±9.96)岁。记录并观察两组患者炎性因子(IL-6、TNF-α、IL-1β)水平与认知功能障碍的相关性。结果治疗前观察组患者体内IL-6、TNF-α、IL-1β水平显著高于对照组,具有统计学差异(P0.05),与治疗前相比较,治疗后观察组IL-6、TNF-α、IL-1β水平有所下降,但下降并不显著,不具有统计学差异(P0.05);观察组的符号编码、言语流畅、持续操作、数字序列、言语记忆、视觉记忆、迷宫、情绪管理以及总成绩与对照组相比较均明显较低,均具有统计学差异(均P0.05);认知障碍组炎性分子水平显著高于对照组,观察组B认知障碍程度比观察组A明显加深,IL-6、TNF-α、IL-1β水平逐渐上升,均具有统计学差异(均P0.05);认知功能障碍与各炎性因子IL-6、TNF-α、IL-1β呈明显正相关(r1=0.738,P0.05;r2=0.317,P0.05;r3=0.106,P0.05);Logistic回归分析结果表明IL-6、TNF-α、IL-1β水平均是认知功能障碍的独立危险因素。结论通过研究表明CSDM患者认知功能障碍与各炎性因子IL-6、TNF-α、IL-1β均呈明显正相关;且Logistic回归分析结果表明IL-6、TNF-α、IL-1β水平均是认知功能障碍的独立危险因素,因此对CSDM患者体内炎性因子(IL-6、TNF-α、IL-1β)水平进行检测,有助于对患者病情进行监控以及治疗方案的制定。
[Abstract]:Objective to explore the correlation between the levels of inflammatory factors (IL-6, TNF- a, IL-1 beta) and cognitive dysfunction in chronic schizophrenia with Chronic schizophrenia with diabetes mellitus (CSDM), and to provide theoretical guidance for clinical treatment. Methods this study was taken back to the mode of study in December 2014 and selected in December of ~2016 year of December 2014. In our hospital, 60 cases of CSDM were treated as the observation group, of which 37 were male and 23 were female, and the age range was 19 years old. The average age was (38.37 + 9.77) years old. The observation group was divided into the observation group A and the observation group B according to the difference of cognitive evaluation. Among them, the observation group was 39 cases of mild cognitive impairment, and the observation group B was 21 cases. Patients with severe cognitive impairment were included: (1) all the subjects were aged 18 years of age ~55 years; (2) all the observation groups were in accordance with the diagnostic criteria for ICD-10 schizophrenia; (3) all the observation groups were CSDM patients; (4) all patients were type 2 diabetes patients, FBG > 6.1mmol/L or 2H PBG > 7.8mmol/L; (5) patients and their families were informed. Consent and signature of informed consent, and approved by the ethics committee of the hospital. Exclusion criteria: (1) suffering from systemic disease; (2) the patients have heart and kidney and other major organ diseases; (3) the patient has a family history of mental illness or psychiatric history; (4) the patient is lactation or special physiological period women; (5) patients have an allergy history or have received immune suppression. 40 volunteers with normal mental condition in the hospital (without the history of mental illness and no family psychiatric history) were selected as the control group, including 27 men, 13 women, ~54 years of age 18, and the average age of (38.64 + 9.96) years old. The levels of inflammatory factors (IL-6, TNF- a, IL-1 beta) were recorded and observed in two groups of patients. Results the level of IL-6, TNF- a, IL-1 beta in the observation group was significantly higher than that of the control group before treatment (P0.05). Compared with the pre treatment group, the level of IL-6, TNF- A and IL-1 beta in the observation group decreased, but the decrease was not significant (P0.05), and the symbol encoding of the observation group was not significant (P0.05). Speech fluency, continuous operation, digital sequence, speech memory, visual memory, maze, mood management and total scores were significantly lower than those of the control group (all P0.05), and the level of inflammatory molecules in the cognitive impairment group was significantly higher than that of the control group. The degree of B cognitive impairment in the observation group was significantly higher than that of the observation group A, IL-6, TNF- a, IL-1 beta. There were statistical differences (all P0.05); cognitive dysfunction was positively correlated with inflammatory factors IL-6, TNF- a, IL-1 beta (r1=0.738, P0.05; r2=0.317, P0.05; r3=0.106, P0.05). Logistic regression analysis showed that IL-6, alpha, and beta were independent risk factors for cognitive dysfunction. The cognitive dysfunction of CSDM patients was positively correlated with the inflammatory factors IL-6, TNF- alpha and IL-1 beta, and the Logistic regression analysis showed that IL-6, TNF- A and IL-1 beta were independent risk factors for cognitive dysfunction. Therefore, the detection of the levels of inflammatory factors (IL-6, TNF- alpha, IL-1 beta) in patients with CSDM was helpful to the patient's condition. Monitoring and treatment plan formulation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3;R587.1

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