本文選題：早期營養(yǎng)不良　切入點：健康和疾病的發(fā)育起源　出處：《重慶醫(yī)科大學》2014年碩士論文

【摘要】：背景阿爾茨海默病(Alzheimer’s disease,AD)的發(fā)病率及死亡率不斷增高，而如今中國正逐步向老齡化社會轉化，如何早期發(fā)現(xiàn)、診斷并治療AD，提高老年人的生活質量，，降低致死、致殘率，將是社會關注的重點。越來越多的研究證實健康和疾病的發(fā)育起源理論的合理性。一些研究也表明早期營養(yǎng)不良和子代后期認知功能障礙密切相關。經歷我國歷史上的三年自然災害(1959-1961)時期的人群，普遍暴露于生命早期營養(yǎng)不良，故對其認知功能的調查，有助于明確早期營養(yǎng)不良對認知功能產生的影響。 目的研究生命早期經歷營養(yǎng)不良，即暴露于中國三年自然災害（1959-1961）人群的認知功能水平，并討論影響認知功能的可能因素。 方法選取2013年10月到2014年3月在重慶醫(yī)科大學附屬第一醫(yī)院體檢中心進行體檢并自愿接受調查的人為研究對象。定義出生在1960.1.1—1961.12.31時期的為胎兒期經歷營養(yǎng)不良組（G2組）。定義之前（1957.1.1—1958.12.31）出生的為嬰幼兒期經歷營養(yǎng)不良組（G1組），及之后（1963.1.1—1964.12.31）出生的為未經歷營養(yǎng)不良組（G3組）。需排除任何可以導致腦功能紊亂的軀體和精神疾病，對符合條件的調查對象進行問卷調查、量表測定，并收集其常規(guī)實驗項目。采用SPSS17.0進行統(tǒng)計學分析，采用卡方檢驗、單因素方差分析或秩和檢驗進行組間分析，各種因素對認知功能的影響因素采用多因素Logistic回歸模型分析。 結果（1）按經歷營養(yǎng)不良時間分組，G1組的認知功能評分為MMSE28.68±1.06、MoCA26.79±1.17，G2組的認知功能評分為MMSE28.53±1.27、MoCA26.47±1.25， G3組的認知功能評分為MMSE29.23±0.89、MoCA27.44±1.09，三組間的MMSE得分P值為0.002，MoCA得分P值為0.000，差異均有統(tǒng)計學意義；（2）按認知功能評分分組，多因素logistic回歸分析結果：胎兒時期經歷營養(yǎng)不良環(huán)境、高LDL水平、吸煙史、性格內向、不善于學習思考是影響認知功能的重要因素。 結論生命早期不同時期暴露于營養(yǎng)不良環(huán)境中，均可能會損害認知功能，且胎兒時期經歷早期營養(yǎng)不良其認知功能損害更明顯。降低LDL水平、不吸煙、養(yǎng)成樂觀向上的性格及培養(yǎng)良好的思考學習習慣，可能為胎兒期經歷早期營養(yǎng)不良的個體預防出現(xiàn)認知功能障礙的方法。
[Abstract]:The background of Alzheimer's disease (Alzheimer 's disease, AD) morbidity and mortality increased, and now Chinese are gradually aging society transformation, how to early detection, diagnosis and treatment of AD, improve the quality of life of the elderly, reduce the mortality and disability rate, will be the focus of social attention. More and more studies have confirmed that the theory of rationality of developmental origins of health and disease. Some studies have shown that early is closely related to malnutrition and offspring later cognitive dysfunction. Experience in the history of our country three years of natural disasters (1959-1961) during the period of the crowd, generally exposed to malnutrition early in life, so on the cognitive function of the investigation, influence to help clear early malnutrition on cognitive function of generation.
Objective to study the cognitive function level of early life malnutrition, which is exposed to three years' natural disasters in China (1959-1961), and discuss the possible factors that influence cognitive function.
Methods from October 2013 to March 2014 as the research object of medical examination at the First Affiliated Hospital of Chongqing Medical University medical center and a voluntary survey. The definition was born in 1960.1.1 - 1961.12.31 during the fetal period experienced malnutrition group (group G2). Before the definition (1957.1.1 - 1958.12.31) for infants born experience malnutrition group (group G1), and after (1963.1.1 - 1964.12.31) was born to experience malnutrition group (group G3). To exclude any brain disorders can lead to physical and mental diseases, conducted a questionnaire survey to investigation object to meet the conditions, scale determination, and collect the conventional experimental project. Using SPSS17.0 for statistical analysis, chi square test, single ANOVA or rank sum test between group analysis, factors of various influencing factors on cognitive function by multi factor Logistic regression model analysis.
Results (1) according to the experience of malnutrition time group, cognitive function score of group G1 is MMSE28.68 + 1.06, MoCA26.79 + 1.17, cognitive function score of group G2 is MMSE28.53 + 1.27, MoCA26.47 + 1.25, cognitive function score of group G3 is MMSE29.23 + 0.89, MoCA27.44 + 1.09, between the three groups of MMSE score P 0.002, the MoCA score of P was 0, there were statistically significant differences; (2) according to the score of cognitive function group, logistic regression analysis results: the fetal period of malnutrition, high LDL levels, smoking history, introverted, not good at thinking and learning are important factors affecting cognitive function.
Conclusion early life in different periods of exposure to poor nutrition environment, may have cognitive function damage, and the fetal period experienced early malnutrition, the cognitive impairment is more obvious. Decrease the level of LDL, not smoking, learning habits to cultivate optimistic personality and develop good thinking, may experience early malnutrition individual prevention methods cognitive impairment for the fetal period.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R749.1

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本文編號：1685497