代谢综合征对皮质下缺血性血管病影像学上脑损害和认知功能的影响

发布时间：2018-04-16 13:24

本文选题：代谢综合征 + 皮质下缺血性血管病　；参考：《安徽医科大学》2014年硕士论文

【摘要】：目的采用改良Scheltens量表对皮质下缺血性血管病（SIVD）影像学上脑损害进行评价，分为脑室旁（PVH）、脑白质（WMH）、基底节（BG）三个脑区评定并量化；Mets的诊断标准采用NCEP-ATP III标准。探讨代谢综合征（Mets）及其各因子对SIVD各个脑区脑损害的影响。材料与方法选取2012年9月-2013年6月安徽医科大学第一附属医院神经内科SIVD患者120例（SIVD组），其中包括非代谢综合征（No-Mets）患者25例，代谢综合征倾向（R-Mets）患者25例，Mets患者70例。Mets的诊断标准采用NCEP-ATPIII标准，受试对象均在空腹状态下采集血液样本用于检测血糖、TG及HDL-C，并测量身高、体重以及腰围，在休息5分钟后测量血压并记录。SIVD脑损害采用改良Scheltens量表对头颅MRI进行评价，，分为脑室旁（PVH）（0-6分）、脑白质（WMH）（0-24分）、基底节（BG）（0-30分）三个脑区评定并计算总分。本研究采用SPSS16.0软件对数据进行了统计学处理，分析Mets及其各因子对SIVD各个脑区脑损害的影响。结果（1）R-Mets组和Mets组PVH、WMH、BG评分、Scheltens总分均显著高于No-Mets组（P均＜0.05）。（2）腰围与WMH评分及Scheltens总分呈显著正相关（P均＜0.05）；甘油三酯（TG）与WMH、BG评分有显著正相关（P＜0.05)；空腹血糖（FPG）与WMH、BG评分以及Scheltens总分呈显著正相关(P＜0.05)；高密度脂蛋白（HDL-C）与WMH、BG评分以及Scheltens总分呈显著负相关(P＜0.05)。（3）进一步多元线性逐步回归分析结果发现FPG、HDL-C与WMH评分显著相关(P均＜0.05)；TG与BG评分显著相关(P＜0.05)；腰围、FPG、HDL-C与Scheltens总分显著相关(P均＜0.05)。结论（1）R-Mets组和Mets组影像学评分较No-Mets组均显著增高；Mets组的WMH、BG评分、Scheltens总分显著高于R-Mets组；（2）腰围与WMH评分及Scheltens总分呈显著正相关；TG与WMH、BG评分有显著正相关；FPG与WMH、BG评分以及Scheltens总分呈显著正相关；HDL-C与WMH、BG评分以及Scheltens总分呈显著负相关。（3）Mets及其各因子与SIVD脑损害相关，其中腹型肥胖、TG、FPG、HDL-C是SIVD 的重要危险因素。
[Abstract]:Objective to evaluate the imaging brain damage of subcortical ischemic vascular disease (Scheltens) by modified Scheltens scale, and divide it into three brain regions: PVHN, WMHG and BGs. NCEP-ATP III was used to evaluate and quantify the diagnostic criteria of subcortical ischemic vascular disease (SIVD).Objective: to investigate the effects of Metabolic Syndrome (Metals) and its factors on brain damage in various brain regions of SIVD.Materials and methods from September 2012 to June 2013, 120 patients with SIVD in Department of Neurology, first affiliated Hospital of Anhui Medical University, including 25 patients with non-metabolic syndrome No-Mets, were selected.NCEP-ATPIII criteria were used in the diagnosis of 25 patients with Metabolic Syndrome (R-Mets) and 70 patients with Mets. Blood samples were collected on an empty stomach to detect TG and HDL-C, and height, weight and waist circumference were measured.After 5 minutes rest, the blood pressure was measured and the brain damage of SIVD was evaluated by modified Scheltens scale. The results were divided into three brain regions: paraventricular MRI (0-6), white matter (WMH) 0-24, basal ganglia (BGG) 0-30).In this study, SPSS16.0 software was used to analyze the effects of Mets and its factors on the brain damage in various brain regions of SIVD.Results the total score of Mets group and R-Mets group were significantly higher than that of No-Mets group (P < 0.05, P < 0.05) the waist circumference was positively correlated with WMH score and Scheltens score (P < 0.05), there was a significant positive correlation between TGG and WMHBG score (P < 0.05), fasting blood glucose (FBG) and WMHHG score and Scheltens score were significantly higher than those in No-Mets group (P < 0.05), and there was a significant positive correlation between WMH score and Scheltens score (P < 0.05), and there was a significant positive correlation between TGG and WMHBG score (P < 0.05), FBG score and WMHHG score (P < 0.05).There was significant positive correlation between HDL-C and Scheltens score (P < 0.05), and significant negative correlation between HDL-C and Scheltens score (P < 0.05). Further stepwise regression analysis showed that HDL-C was significantly correlated with WMH score (P < 0.05), and there was significant correlation between HDL-C and BG score (all P < 0.05), and there was a significant correlation between HDL-C and WMH score (P < 0.05), and significant correlation (P < 0.05) between HDL-C and Scheltens score (P < 0.05), and significant correlation (P < 0.05) between HDL-C and WMH score (P < 0.05).There was significant correlation between HDL-C and total score of Scheltens (P < 0.05).ConclusionThe imaging scores of R-Mets group and Mets group were significantly higher than those of No-Mets group.(2) there was a significant positive correlation between waist circumference and WMH score and total Scheltens score. There was a significant positive correlation between TG and WMHBG score and Scheltens score. There was a significant negative correlation between HDL-C and WMHHBG score, and a significant negative correlation between Scheltens total score and SIVD brain damage.The HDL-C of the abdominal obesity group is SIVD.Important risk factors.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R589;R743

【参考文献】