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大同醫院「阿茲海默症」研究 [記憶及老化中心]盼及早預防@電傳媒

Posted On By 吳 富正

【電傳媒-記者吳富正、湯玉婷/2020.08.16.高雄報導】

 高雄市立大同醫院[記憶及老化中心]楊淵韓主任分享,「阿茲海默症」是退化性腦病變疾病,會漸進式破壞心智功能,患者罹病後逐步失去記憶,且有明顯的人格改變,為目前最常見的失智原因,是耗費最多健保資源的疾病之一,「阿茲海默症」真正的成因至今仍然不明,高雄市立大同醫院擁有高雄醫學大學教學研究資源,攜手國立中山大學共同整合中醫舌診、動態平衡、無線多頻道腦波及三維空間人臉辨識等研究項目,發現阿茲海默症患者因為腦部神經退化,腦波頻率變得較慢,靈活度及協調性也較健康人低。

 楊淵韓主任指出,根據研究類澱粉蛋白本來應該要經過後轉譯修飾的,但是在「阿茲海默症」病人身上,這個修飾的機制出了問題,原因可能來自基因緣故。後轉譯修飾功能異常會製造出一堆異常的碎片,叫做「β類澱粉蛋白」(amyloid beta / A-beta, Aβ),堆積成有毒的斑塊,甚至會產生毒性更強的寡果體(oligomer),且在腦部累積時是多面向的,所以可能累積在運動皮質(負責管理運動、平衡及協調)、聯合皮質區或其他大腦皮質沉澱,臨床上或許症狀輕微不易發現,因而失去早期診斷的機會及接下來治療的契機;沒有辦法用肉眼判斷的缺失,或許可利用機器的人工智慧來補足。

 楊淵韓主任提及,大同醫院記憶及老化中心目前已收案約500位阿茲海默症病人,每位病人都接受舌診、平衡系統偵測、三維空間人臉辨識系統及無線多頻道腦波檢查,利用這些生理訊號客觀的評估阿茲海默症。研究發現這些指標在這群病人裡面,除了記憶退化之外,其他運動及協調功能退化速度確實也異於正常人,亦於研究中發現阿茲海默症患者因為腦部神經退化,腦波頻率變得較慢,腦部的不對稱性及平衡功能也較健康人低。此外針對極早期及早期病患,大同醫院亦與高雄醫學大學合作,在國家衛生研究院協助下完成認知功能非藥物介入之健體顧腦指引手冊,此等多重訓練模組的非藥物介入已證實可減緩認知功能退化,也已發表在國際期刊,若能及早發現病患,予以介入或能達到最好的治療效果。

 大同醫院黃志富院長表示,失智症病患治療固然重要,但找出潛在危險的個案可能更重要,過去我們的研究發現失智症患者的子女有較高比例會罹患失智症,如又合併三高及E型脂蛋白基因特異,日後更可能發展為失智症。目前大同醫院正推動「失智症成人子女研究計畫 (adult children study)」,針對患者子女展開追蹤研究,如同將失智症研究往前推20、30年,期望能找到患者發病前的整合性生物標記,能及早預防,延緩發病時程,降低後續醫療費用支出,也減少對家庭社會的衝擊。

高雄市立大同醫院http://www.kmtth.org.tw/

高雄市立大同醫院FBhttps://www.facebook.com/kmtth/

高雄市前金區中華三路68號(07)291-1101

吳 富正
2udn011@gmail.com

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