阿尔茨海默病可控性危险因素的临床研究  

Clinical study of controllable risk factors for Alzheimer's disease

作　　者：李晶[1] 周仁华[1] 侍永伟 沈骏[1] Li Jing;Zhou Renhua;Shi Yongwei(Department of Neurology,the Forth People’s Hospital of Taizhou,Taizhou 225300)

机构地区：[1]泰州市第四人民医院神经内科,江苏泰州225300

出　　处：《中国现代医药杂志》2023年第4期26-31,共6页Modern Medicine Journal of China

基　　金：泰州市科技计划项目(编号:SSF20209814)。

摘　　要：目的通过分析可能促进阿尔茨海默病(Alzheimer's disease,AD)发生发展的可控性危险因素,从而指导制定预防及治疗策略。方法将2019年7月~2022年4月在我院住院的51例AD患者纳入研究作为AD组,同时纳入同期年龄相匹配的、在我院体检的健康老年人作为健康对照组,两组均完成一般资料收集,并完成血脂、同型半胱氨酸(Hcy)、N末端-B型钠尿肽前体(NT-proBNP)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、D-二聚体等指标检测,将两组患者临床资料进行对比。结果两组高血压、糖尿病、冠心病发病率、血清白蛋白、血红蛋白、血脂、血糖比较,差异无统计学意义(P>0.05);两组间体重指数(BMI)、NT-proBNP、Hcy、FT3、T3、TSH、D-二聚体比较差异均有统计学意义(P<0.05);二元Logistic回归分析发现,低BMI、高Hcy是AD发生的独立危险因素(OR=0.741,P=0.008;OR=1.235,P=0.001);线性回归发现,BMI与MMSE评分呈正相关(R 2=0.599)。结论老年患者易处于低体重状态,低BMI可能对AD患者的脑功能产生有害影响,可能促进AD的发生发展;高Hcy水平与AD的发生呈正相关,降低Hcy水平可能有助于减少AD的发生、减缓疾病的进展。Objective To investigate the controllable risk factors that may contribute to the development of Alzheimer's disease(AD),so as to guide the formulation of prevention and treatment strategies.Methods A total of 51 AD patients hospitalized in our hospital from Jul 2019 to Apr 2022 were included in the AD group,and healthy elderly with matching age who underwent physical examination in our hospital during the same period were included as the health control group.General date were collected and the level of blood lipid,homocysteine(Hcy),N-terminal B-type natriuretic peptide precursor(NT-proBNP),D-dimer,FT3,FT4,T3,T4,TSH and other indicators were detected,and the data of the two groups were compared.Results There were no statistically significant differences in the incidence rates of hypertension,diabetes,coronary heart disease,serum albumin,hemoglobin,blood lipid and blood glucose between two groups(P>0.05).There were statistically significant differences in BMI,NT-proBNP,Hcy,FT3,T3,TSH and D-dimer between two groups(P<0.05).Multivariate Logistic regression analysis showed that low BMI and high Hcy levels were independent risk factors for AD(OR=0.741,P=0.008;OR=1.235,P=0.001).Linear regression showed that BMI was positively correlated with MMSE score(R 2=0.599).Conclusion Be prone to low body weight and low BMI,elderly patients'brain function may have harmful effects,which may promote the occurrence and decelopment of AD.Be positively correlated with AD,High Hey level should be decreased to reduce the onset of AD and slow down the progression of the disease.

关 键 词：阿尔茨海默病 体重指数 甲状腺功能 N末端-B型钠尿肽前体 同型半胱氨酸 D-二聚体 

分 类 号：R749.16[医药卫生—神经病学与精神病学]