生命早期暴露于中国饥荒年（1959年至1961年）人群认知状态的研究

Research on the cognition of people exposed to the Chinese famine（1959-1961） in early life

摘要:

目的：探讨生命早期暴露于中国三年自然灾害（1959至1961年）的人群认知功能。方法：从2013年5月至2014年5月以本院健康体检人群为研究对象，共计718例。按出生日期分为3组：出生于1956年10月1至1958年9月30日定义为婴幼儿期暴露于饥荒年组（G1组），共236例；出生于1959年10月1日至1961年9月30日为胎儿期暴露于饥荒年组（G2组），共240例。出生于1962年10月1日至1964年9月30日为未暴露于饥荒年组（G3组），共242例。对3组人群进行听觉词语学习测试华山版（auditory verbal learning test-huashan version，AVLT-H）、简易智能量表（mini-mental state examination，MMSE）、蒙特利尔量表（Montreal cognitive assessment scale，MoCA）、日常生活行为量表（activity of daily living scale，ADL）测试以及一般情况调查，并对结果进行比较分析。结果：3组在AVLT-H量表的短延迟回忆、长延迟回忆、线索回忆、再认方面以及MMSE、MoCA量表得分有统计学差异（P=0.000），且G1组、G2组得分低于G3组。G1组轻度认知功能障碍（mild cognitive impairment，MCI）患病率为5.08%、G2组MCI患病率为5.00%，高于G3组MCI患病率3.72%，但无统计学差异（G1 vs. G3， ?字2=0.527，P=0.468;G2 vs.G3， ?字2=0.471，P=0.492）。结论：生命早期不同时期暴露于营养不良环境有可能影响成年后的认知功能。对于这部分人群采取必要措施防止MCI的发生以及MCI转化为阿尔茨海默病（Alzheimer’s disease，AD）有重要意义。

Abstract:

Objective：To study the cognition of people who were exposed to the Chinese famine（1959-1961） in their early life. Methods：From may 2013 to may 2014，718 subjects in health center of the First Affiliated Hospital of Chongqing Medical University were studied. All subjects were divided into three groups according to the date of birth：subjects who were born before the famine（1956.10.1-1958.9.30） were regarded as G1 group（236 cases）；subjects who were born during the famine（1959.10.1-1961.9.30） were chosen as G2 group（240 cases）；subjects who were born after the famine（1962.10.1-1964.9.30） were chosen as G3 group（242 cases）. The three groups finished auditory verbal learning test-huashan version（AVLT-H），mini-mental state examination（MMSE），Montreal cognitive assessment scale（MoCA），activity of daily living scale（ADL） and the general information survey. The the results were analyzed. Results：There were statistically significant differences in the short term and long term delayed recall，clue memory，recognized memory in AVLT-H，MMSE and MoCA（P=0.000）；the scores were lower in G1 and G2 groups than in G3 group. The preva－lence of MCI was 5.08%，5.00%，3.72% in G1，G2，G3 groups，respectively（G1 vs. G3， ?字2=0.527，P=0.468；G2 vs. G3， ?字2=0.471，P=0.492）. Conclusion：Different periods of early life exposed to the malnourished environment may have influences on the cognition in adulthood. So it is meaningful for these people to take measures to prevent the occurrence of mild cognitive impairment（MCI） and Alzheimer’s disease translated from MCI.