人类血浆脂蛋白相关磷脂酶A2（Lp-PLA2）与轻度认知功能障碍的相关性研究
发布时间：2018-08-29 12:17
【摘要】：目的:轻度认知功能障碍是一种介于正常衰老与痴呆之间的不稳定过渡状态,处在这个阶段的患者存在高于其年龄阶段允许的认知功能障碍,患者日常生活能力不受影响,存在认知功能障碍且达不到痴呆的诊断标准,其在极短时间内便可能发展为痴呆。且所有治疗痴呆的药物均会对人体造成损害。故在轻度认知功能障碍阶段,积极控制危险因素,早发现,早干预,对于提高轻度认知功能障碍患者的生活质量具有重要意义。本研究用人类血浆脂蛋白相关磷脂酶A2(Lp-PLA2)对轻度认知功能障碍进行风险评估;探讨影响轻度认知功能障碍的危险因素;研究LP-PLA2水平与轻度认知功能障碍之间的关系。方法:回顾性分析2016年5月—2016年12月在陕西省人民医院住院治疗的轻度认知功能障碍患者100例(研究组),以及同时期的健康体检者100例(对照组)。对所有入选的轻度认知功能障碍患者和健康体检者进行MoCA评分,分别对比Lp-PLA2的活性。所有入选对象入院后3天内采用蒙特利尔认知评估量表(MoCA)检查患者的认知功能,并对MoCA评分进行统计;探测轻度认知功能障碍组患者和健康体检者的Lp-PLA2水平;统计所有入选对象的年龄、性别、脑卒中史、文化程度、吸烟史、饮酒史、高血压、糖尿病、冠心病、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),分析各指标对MoCA评分的影响;分析轻度认知功能障碍组患者Lp-PLA2水平与MoCA评分的相关性。数据经过处理后,采用SPSS 22.0统计软件进行分析,P0.05有统计学意义。结果:1.研究组Lp-PLA2水平与MoCA评分呈负相关性(r=-0.62,P0.05)。2.两组相比,轻度认知功能障碍组患者的Lp-PLA2水平明显高于健康对照组患者,差异具有统计学意义(P0.05),且Lp-PLA2水平越高,MoCA评分越低。3.轻度认知功能障碍组患者中,男性为64%,女性占到36%,且男性患者的LpPLA2水平明显高于女性患者,差异具有统计学意义(P0.05);男性患者MoCA评分明显低于女性患者,差异具有统计学意义(P0.05)。4.研究组中受教育年限12年的患者Lp-PLA2水平低于≤12年的患者,但差异无统计学意义(P0.05);12年的患者Mo CA评分明显高于≤12年的患者,差异具有统计学意义(P0.05)。5.饮酒史、脑卒中史、糖尿病史对轻度认知功能障碍有影响,吸烟史、高血压史、冠心病史、LDL、HDL、TG、TC对轻度认知功能障碍无影响。6.HDL与MoCA评分之间有正相关性(r=0.165,P=0.02),年龄、Lp-PLA2与MoCA评分之间有负相关性(r=-0.403,P=0.00;r=-0.413,P=0.00);而LDL、TG、TC与MoCA评分无相关性。7.Lp-PLA2是轻度认知功能障碍发生的独立影响因素。结论:1.Lp-PLA2与轻度认知功能障碍具有相关性,Lp-PLA2水平越高,轻度认知功能障碍越严重。2.轻度认知功能障碍患者中男性的发病率要高于女性。3.轻度认知功能障碍患者中受教育年限12年的MoCA评分要明显高于≤12年的患者。4.HDL与MoCA评分之间有正相关性,年龄、Lp-PLA2与MoCA评分之间有负相关性。5.Lp-PLA2是轻度认知功能障碍发生的独立影响因素。
[Abstract]:Objective: Mild cognitive impairment is an unstable transitional state between normal aging and dementia. At this stage, patients have cognitive impairment which is higher than their age, their daily living ability is unaffected, their cognitive impairment is not up to the diagnostic standard of dementia, and they have stool in a very short time. It may develop dementia, and all drugs for dementia can cause damage to the human body. Therefore, it is important to actively control risk factors, early detection and early intervention in the stage of mild cognitive impairment to improve the quality of life in patients with mild cognitive impairment. Methods: A retrospective analysis of 100 patients with mild cognitive impairment hospitalized in Shaanxi Provincial People's Hospital from May 2016 to December 2016 was conducted. All patients with mild cognitive impairment and healthy subjects were assessed with MoCA and compared with the activity of Lp-PLA2. All subjects were assessed with the Montreal Cognitive Assessment Scale (MoCA) within 3 days after admission, and the scores of MoCA were detected. Levels of Lp-PLA2 in patients with mild cognitive impairment and healthy subjects were measured, and age, sex, stroke history, education level, smoking history, drinking history, hypertension, diabetes, coronary heart disease, triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were analyzed. The correlation between Lp-PLA2 level and MoCA score in patients with mild cognitive impairment was analyzed. The data were processed and analyzed by SPSS 22.0 statistical software. The results showed that: 1. There was a negative correlation between Lp-PLA2 level and MoCA score (r =-0.62, P 0.05). The level of LP-PLA2 in patients with mild cognitive impairment was 64% in males and 36% in females, and the level of LP-PLA2 in males was significantly higher than that in females (P 0.05). The MoCA score of male patients was significantly lower than that of female patients (P 0.05). 4. The Lp-PLA2 level of patients with 12 years of education was lower than that of patients with 12 years of education, but there was no significant difference (P 0.05); the MoCA score of patients with 12 years of education was significantly higher than that of patients with 12 years of education (P 0.05). Stroke history and diabetes mellitus history had an impact on mild cognitive impairment. Smoking history, hypertension history, coronary heart disease history, LDL, HDL, TG, TC had no effect on mild cognitive impairment. 6. There was a positive correlation between HDL and MoCA score (r = 0.165, P = 0.02), age, Lp-PLA2 and MoCA score were negatively correlated (r = - 0.403, P = 0.00; r = - 0.413, P = 0.00), while LDL, TG, TG, and TC were negatively correlated. Lp-PLA2 was associated with mild cognitive impairment. The higher the Lp-PLA2 level, the more severe the mild cognitive impairment. 2. The incidence of mild cognitive impairment in males was higher than that in females. 3. Mild cognitive impairment. There was a positive correlation between HDL and MoCA score. Age, Lp-PLA2 and MoCA score were negatively correlated. 5. Lp-PLA2 was an independent factor for mild cognitive impairment.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.16
本文编号：2211184
[Abstract]:Objective: Mild cognitive impairment is an unstable transitional state between normal aging and dementia. At this stage, patients have cognitive impairment which is higher than their age, their daily living ability is unaffected, their cognitive impairment is not up to the diagnostic standard of dementia, and they have stool in a very short time. It may develop dementia, and all drugs for dementia can cause damage to the human body. Therefore, it is important to actively control risk factors, early detection and early intervention in the stage of mild cognitive impairment to improve the quality of life in patients with mild cognitive impairment. Methods: A retrospective analysis of 100 patients with mild cognitive impairment hospitalized in Shaanxi Provincial People's Hospital from May 2016 to December 2016 was conducted. All patients with mild cognitive impairment and healthy subjects were assessed with MoCA and compared with the activity of Lp-PLA2. All subjects were assessed with the Montreal Cognitive Assessment Scale (MoCA) within 3 days after admission, and the scores of MoCA were detected. Levels of Lp-PLA2 in patients with mild cognitive impairment and healthy subjects were measured, and age, sex, stroke history, education level, smoking history, drinking history, hypertension, diabetes, coronary heart disease, triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were analyzed. The correlation between Lp-PLA2 level and MoCA score in patients with mild cognitive impairment was analyzed. The data were processed and analyzed by SPSS 22.0 statistical software. The results showed that: 1. There was a negative correlation between Lp-PLA2 level and MoCA score (r =-0.62, P 0.05). The level of LP-PLA2 in patients with mild cognitive impairment was 64% in males and 36% in females, and the level of LP-PLA2 in males was significantly higher than that in females (P 0.05). The MoCA score of male patients was significantly lower than that of female patients (P 0.05). 4. The Lp-PLA2 level of patients with 12 years of education was lower than that of patients with 12 years of education, but there was no significant difference (P 0.05); the MoCA score of patients with 12 years of education was significantly higher than that of patients with 12 years of education (P 0.05). Stroke history and diabetes mellitus history had an impact on mild cognitive impairment. Smoking history, hypertension history, coronary heart disease history, LDL, HDL, TG, TC had no effect on mild cognitive impairment. 6. There was a positive correlation between HDL and MoCA score (r = 0.165, P = 0.02), age, Lp-PLA2 and MoCA score were negatively correlated (r = - 0.403, P = 0.00; r = - 0.413, P = 0.00), while LDL, TG, TG, and TC were negatively correlated. Lp-PLA2 was associated with mild cognitive impairment. The higher the Lp-PLA2 level, the more severe the mild cognitive impairment. 2. The incidence of mild cognitive impairment in males was higher than that in females. 3. Mild cognitive impairment. There was a positive correlation between HDL and MoCA score. Age, Lp-PLA2 and MoCA score were negatively correlated. 5. Lp-PLA2 was an independent factor for mild cognitive impairment.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.16
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