社区阿尔茨海默病患者血中相关元素、神经递质的含量与分布特点  

Epidemiological analysis for community Alzheimer' s patients and their related elements,neurotransmitter in blood

作　　者：黄河浪[1] 吴磊[1] 吴一峰[1] 冯江[1] 袁也丰[2] 周建明[3] 

机构地区：[1]南昌大学公共卫生学院流行病学教研室,江西南昌330006 [2]南昌大学第一附属医院身心医学科,江西南昌330006 [3]南昌大学医学实验教学部,江西南昌330006

出　　处：《中华疾病控制杂志》2012年第5期382-387,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(30760214)

摘　　要：目的了解社区阿尔茨海默病(Alzheimer's disease,AD)的现患率,探索患者血液中相关元素和神经递质的含量与分布特点以及对该病的影响。方法采用整群抽样的方法抽取江西省3市6个社区4 614人为研究对象,对其进行宏、微量元素及相关神经递质检测。结果江西省城市社区老年人群AD患病率为4.92%,处中等偏高水平,患病率随着年龄升高呈增加趋势,女性患病率略高于男性;AD患者以中型最多(51.40%)。AD和非AD人群血中9种化学元素、3种神经递质含量与分布存在一定差异;AD组Al、Mn、Cu元素含量高于非AD组,差异均有统计学意义;Se、Cr结果则相反。在两组人群中,未见这些元素含量的分布随年龄改变出现明显变化,男性AD患者的Ca、Zn和Cd 3种元素的含量明显高于女性患者;五羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(dopamine,DA)和乙酰胆碱受体自身抗体(acetylcholine receptor antibody,AchR-Ab)含量与分布中,非AD组5-HT和DA含量高于AD组(均有P<0.05),AD组AchR-Ab高于非AD组。多因素分析结果显示,血Al高、性格内向、离婚或丧偶是AD发(患)病的危险因素,而血Cr和5-HT含量高为AD发病的保护因素。结论江西省城市社区AD患病率处中等偏高水平且以中型患者多见;AD和非AD两种不同人群血Al、Mn、Cu、Se、Cr和5-HT、DA、AchR-Ab的含量存在明显差异;血Al、血Cr、5-HT、性格、婚姻状况5个因素为AD的主要影响因素。Objective To understand the prevalence of community Alzheimer＇ s disease（AD）,and also explore the content and distribution of related elements and neurotransmitter in the patient＇ s blood,as well as their impact of AD.Methods 4 614 cases from 6 communities were investigated by cluster sampling method.The level of macro element,trace element and neurotransmitters were tested.Results The prevalence of AD in elderly community population was increased with age in some cities of Jiangxi Province,at high-middle level（4.92%）,female was higher than male;51.40% of AD patient have the middle level signs.Compared with 9 blood chemical elements,3 neurotransmitters of AD and non-AD groups： the level of Al,Mn,Cu of AD group were significantly higher than those of non-AD group,while Se,Cr were opposite.No significant changes with age were shown in these elements of two groups.In male patients,the level of Ca,Zn and Cd were significantly higher than female;5-hydroxytryptamine（5-HT） and dopamine（DA） were higher in control group,while acetylcholine receptor antibody（AchR-Ab） was higher in case group.Multivariate analysis showed that high Al,introverted,divorced or widowed were the risk factors of AD,and high levels of Cr and 5-HT were protective factors.Conclusions AD prevalence is in high-middle level in communities and mostly are medium state;compared with AD and non-AD group,Al,Mn,Cu,Se,Cr,and 5-HT,DA,AchR-Ab levels are significant different;Al,Cr,5-HT,personality,marital status are five key factors of AD.

关 键 词：阿尔茨海默病 元素 神经递质药 老年医学 

分 类 号：R181.3[医药卫生—流行病学] R745.1[医药卫生—公共卫生与预防医学]