本文選題：血管性認(rèn)知功能損害(VCI) + 血管性癡呆(VaD)�。� 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]分析研究血管性認(rèn)知功能障礙(VCI)患者尿液中阿爾茨海默病相關(guān)神經(jīng)絲蛋白(AD7c-NTP)含量改變的相關(guān)因素以及與正常人尿液中含量差別,從而對(duì)臨床中VCI患者的早期診斷、干預(yù)提供依據(jù)及參考。[方法]篩選收集昆明醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科2016年3月～2017年3月VCI患者29例,男18例,女11例,年齡21-76歲,平均年齡51±11.7歲。病程1周至10年不等。納入患者均有腦血管疾病高危因素或腦梗塞、腦出血病史,且生命體征和神經(jīng)功能癥狀已平穩(wěn)1天以上,無(wú)意識(shí)障礙,無(wú)明顯失語(yǔ)及視聽(tīng)功能障礙,Rankin Scale評(píng)分≤3分(見(jiàn)附錄)。均排除意識(shí)障礙患者及有頭部外傷、腫瘤、手術(shù)病史患者。排除有精神疾病患者,有失語(yǔ)及構(gòu)音功能缺損影響評(píng)估的患者,病情尚不穩(wěn)定或伴有嚴(yán)重并發(fā)癥。所有納入患者的臨床癥狀及進(jìn)行神經(jīng)心理量表測(cè)試、頭顱MRI、頭顱CT,或腦電圖(EEG)、經(jīng)顱多普勒(TCD)等檢查均證實(shí)有VCI的存在。對(duì)照組收集本時(shí)間段在我院行該檢測(cè)的人員共計(jì)20例,男女各10例;年齡20-75歲,平均為50±14.8歲;納入人員均排除高血壓、糖尿病、腦血管疾病病史、明顯頭部外傷、腫瘤、手術(shù)病史以及患有精神疾病的人員;且經(jīng)MMSE量表評(píng)分均26分且MoCA量表評(píng)分均26分。采集實(shí)驗(yàn)組及對(duì)照組人員的清晨隨機(jī)中段尿液20ml,將留取到合格的尿液標(biāo)本在內(nèi)分泌科實(shí)驗(yàn)室進(jìn)行檢測(cè),獲取標(biāo)本AD7c-NTP表達(dá)水平的數(shù)據(jù)。將所得數(shù)據(jù)運(yùn)用SPSS 13.0統(tǒng)計(jì)軟件進(jìn)行處理與分析。運(yùn)用中位數(shù)和四分位數(shù)間距[M(P25,P75)]對(duì)數(shù)據(jù)進(jìn)行描述,用秩和檢驗(yàn)(Wilcoxon兩樣本比較法)進(jìn)行組與組對(duì)比檢驗(yàn)。[結(jié)果]VCI組患者尿液AD7c-NTP表達(dá)水平在中位數(shù)[0.61(0.33,1.12)]上略大于對(duì)照組[0.59(0.22,0.87)]。但經(jīng)統(tǒng)計(jì)學(xué)分析,VCI組與對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.34070.05)。根據(jù)MMSE量表認(rèn)知功能障礙程度分組中的輕度認(rèn)知功能障礙組[0.43(0.27,0.81)]表達(dá)水平小于中度認(rèn)知功能障礙組[1.14(0.88,1.38)],差異有統(tǒng)計(jì)學(xué)意義(P=0.00590.05)。根據(jù)性別男性組[0.68(0.36,1.12)]表達(dá)水平大于女性組[0.49(0.05,1.14)],差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.53040.05)。根據(jù)年齡55≤歲組[0.45(0.27,1.12)]表達(dá)水平明顯小于55 歲組[0.76(0.47,1.07)],差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.21380.05)。[結(jié)論]1.通過(guò)本組研究表明:VCI組患者尿液中AD7c-NTP表達(dá)水平[0.61(0.33,1.12)]大于對(duì)照組[0.59(0.22,0.87)],但差異無(wú)統(tǒng)計(jì)學(xué)意義。盡管統(tǒng)計(jì)學(xué)未達(dá)到差異標(biāo)準(zhǔn),但在長(zhǎng)期的觀察中,臨床上VCI患者尿液中AD7c-NTP確有升高趨勢(shì),具體關(guān)系仍待進(jìn)一步研究。2.VCI患者中,尿液中AD7c-NTP表達(dá)水平和患者認(rèn)知功能障礙程度呈相關(guān)性:中度認(rèn)知功能障礙患者尿液中AD7c-NTP表達(dá)水平較輕度患者明顯增高(P0.05);本次實(shí)驗(yàn)結(jié)果暫表明AD7c-NTP表達(dá)水平不受年齡與性別的影響。
[Abstract]:[objective] to study the factors related to the changes of urinary AD7c-NTP in patients with vascular cognitive impairment (VCI) and the difference between the levels of AD7c-NTP and normal urine, and to evaluate the early diagnosis of patients with VCI. To provide basis and reference for intervention. [methods] A total of 29 VCI patients, male 18 and female 11, aged 21-76 years, with an average age of 51 鹵11.7 years, were selected from Neurosurgery Department of the first affiliated Hospital of Kunming Medical University from March 2016 to March 2017. The course of disease ranged from 1 week to 10 years. All the patients involved had high risk factors of cerebrovascular disease or cerebral infarction, history of cerebral hemorrhage, stable vital signs and neurological symptoms for more than 1 day, no significant aphasia and visual impairment and Rankin scale score 鈮，

本文編號(hào)：2115443