神经内分泌变化对帕金森病痴呆的影响

发布时间：2018-04-24 06:45

本文选题：帕金森病 + 帕金森病痴呆　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:本试验通过检测血促甲状腺素(TSH)、游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、促肾上腺皮质激素(ACTH)、皮质醇(cortisol)、糖化血红蛋白(HbAlc)来说明神经内分泌变化对帕金森病非痴呆患者及帕金森病痴呆患者的影响,进一步探讨帕金森病及其认知障碍与神经内分泌间的潜在关系,为预防帕金森病痴呆提供依据。方法:收集2015年12月1日-2016月12月30日山西医科大学第一医院确诊的帕金森病非痴呆患者(n-PDD)42例,帕金森病痴呆患者(PDD)21例及同期对照组20例,收集其一般临床资料如性别、年龄、受教育年限、病程及H-Y分级;由两名专业的神经心理测评员对其进行MMSE评分及ADL评分,对PDD组进行NPI评分;于晨起6时空腹状态下抽取静脉血15ml,用全自动生化仪检测血TSH、FT3、FT4、ACTH、皮质醇、HbAlc,采用统计软件SPSS21.0处理数据,定量资料表示为均数±标准差,两组均数间的比较采用两独立样本t检验,多组均数比较采用单变量方差分析,多个样本均数间的多重比较,采用LSD-t检验,P0.05认为差异有统计学意义。结果:PDD组、n-PDD组的年龄,受教育年限的差异无统计学的意义(P0.05);病程、H-Y分级的差异有统计学的意义(P0.05),PDD组的病程较长,H-Y分级较高。HPT轴:PDD组、n-PDD、对照组的TSH分别为:2.79±1.11、2.74±1.03、2.04±0.86,PDD组、n-PDD、对照组的FT3分别为:4.28±0.77、4.41±0.69、4.86±0.96,PDD组、n-PDD、对照组的FT4分别为:14.99±2.35、14.77±2.65、13.22±2.19,PDD组、n-PDD组的TSH、FT3、FT4与对照组相比,差异有统计学意义(P0.05),PDD组、n-PDD组两组间上述指标的比较差异无统计学意义(P0.05),PDD组、n-PDD组的TSH、FT4比对照组高,FT3比对照组低。HPA轴:PDD组、n-PDD组、对照组的ACTH分别为:7.15±2.75、7.96±2.61、9.70±3.65,PDD组、n-PDD组、对照组的皮质醇分别为:431.87±170.63、351.21±133.90、330.02±106.76,PDD组、n-PDD组的ACTH与对照组相比,差异有统计学意义(P0.05),PDD组、n-PDD组间ACTH的比较差异无统计学意义(P0.05),PDD组与n-PDD组、对照组的皮质醇相比,差异有统计学意义(P0.05),n-PDD、对照组的皮质醇的比较,差异无统计学意义(P0.05),PDD、n-PDD组的ACTH比对照组低,PDD组的皮质醇高于n-PDD与对照组。PDD组、n-PDD组、对照组的HbAlc分别为:6.01±0.59、5.91±0.84、5.41±0.42。PDD组、n-PDD组的HbAlc与对照组相比,差异有统计学意义(P0.05),PDD组、n-PDD组间HbAlc的比较,差异无统计学意义(P0.05),PDD、n-PDD组的HbAlc比对照组高。结论:帕金森病痴呆与帕金森病非痴呆患者的血TSH、FT4、HbAlc水平较高,血ACTH、FT3水平低下,帕金森病痴呆患者的血皮质醇增高。血TSH、FT4、FT3、HbAlc、ACTH对帕金森病痴呆可能无影响,血皮质醇水平升高对帕金森病痴呆可能有一定的影响。神经内分泌变化可为预防帕金森病痴呆提供依据。
[Abstract]:Objective: to investigate the effect of neuroendocrine changes on Parkinson's disease (PD) by detecting TSH, free triiodothyronine, free thyroxine FT4, adrenocorticotropic hormone (ACTH), cortisol cortisola and glycosylated hemoglobin (HbAlc). The effects of dementia and Parkinson's disease, To further explore the potential relationship between Parkinson's disease, its cognitive impairment and neuroendocrine, and to provide evidence for the prevention of Parkinson's disease dementia. Methods: from December 1, 2015 to December 30, 2010, 42 patients with Parkinson's disease diagnosed as non-dementia, 21 patients with Parkinson's disease with PDD and 20 controls were collected. The general clinical data such as sex and age were collected. The length of education, course of disease and H-Y grade were evaluated by two professional neuropsychological evaluators on MMSE score and ADL score, and NPI score on PDD group. Venous blood was collected at 6 am at 6 am. Blood TSHFT3FT4FT4ACTH, cortisol HbAlc were detected by automatic biochemical instrument. The data were processed by statistical software SPSS21.0, and the quantitative data were expressed as mean 卤standard deviation. The comparison between the two groups was performed by two independent samples t test. The multigroup mean was compared by univariate analysis of variance and the multiple comparison between the mean of multiple samples. The difference was statistically significant by using LSD-t test (P0.05). Results the age of the 20% PDD group was compared with that of the n-PDD group. There was no significant difference in the number of years of education (P 0.05), but there was significant difference in the course of disease (P 0.05) and the FT3 of the control group was: 4.28 卤0.774.41 卤0.774.41 卤0.69 卤0.96 卤0.96 卤0.96 卤0.96 卤0.96 卤0.96 卤0.96; The FT4 of the control group was 14. 99 卤2. 35 卤14. 77 卤2. 65 and 13. 22 卤2. 19 respectively. Compared with the control group, the FT4 of the n-PDD group was higher than that of the control group. There was no significant difference in the above indexes between the two groups. The ACTH of the control group was lower than that of the control group. The ACTH of the control group was 7. 15 卤2. 75 卤2. 71 卤2. 61 卤9. 70 卤3. 65% and that of the control group was 7. 15 卤2. 75 卤2. 61 卤9. 70 卤3. 65% respectively. The ACTH of n-PDD group was significantly higher than that of control group (P 0.05). There was no significant difference in ACTH between P0.05PDD group and n-PDD group, and there was no significant difference in cortisol between P0.05PDD group and n-PDD group. There was no significant difference in cortisol between the control group and the control group. The ACTH of the PDD group was higher than that of the control group, and the HbAlc of the control group was 6.01 卤0.595.91 卤0.84 卤0.84 卤0.42.PDD and that of the control group was higher than that of the control group. There was no significant difference in HbAlc between P0.05 and PDD groups. The HbAlc of the P0.05-PDD n-PDD group was higher than that of the control group. Conclusion: the serum levels of TSHFT4 and HbAlc in patients with Parkinson's disease and Parkinson's disease are higher than those in patients with Parkinson's disease, and the levels of ACTH / FT3 are lower, and cortisol is higher in patients with dementia with Parkinson's disease. The serum TSHFT4 FT3 HbAlcACTH may have no effect on Parkinson's disease dementia, but elevated serum cortisol level may have a certain effect on Parkinson's disease dementia. Neuroendocrine changes may provide evidence for the prevention of Parkinson's disease dementia.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5

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