血浆同型半胱氨酸水平、脑萎缩与认知障碍的相关性研究

Correlation Study on Plasma Homocysteine,Brain Atrophy and Cognitive Impairment

目的探讨认知障碍程度与血浆同型半胱氨酸(Hcy)水平、脑萎缩系列指标的相关性。方法将研究对象分为重度AD、中度AD、轻度AD、MCI、正常对照五组,测定其血浆Hcy水平和哈氏值、侧脑室体部指数、沟间距、左右外侧裂宽度、第三脑室宽度几项指标,并研究其统计学相关性。结果随认知障碍程度的增加,血浆同型半胱氨酸水平也增加,Hcy浓度与重度AD、中度AD、轻度AD、MCI、正常对照五组的MMSE评分Spearman分析分别为r=-0.365、r=-0.389、r=-0.433、r=-0.424、r=-0.412;沟间距、左侧外宽度、右侧外宽度、第三脑室密度和哈氏值均与MMSE评分呈明显的负相关,Spearman分析分别为r=-0.457,r=-0.629,r=-0.636,r=-0.701,r=-0.533,而侧脑室体部指数与MMSE评分呈明显的正相关,Spearman分析r=0.654;Logistic回归模型结果显示Hcy浓度、左侧外宽度、侧脑室体部指数和哈氏值在各组的比较差异有统计学意义(P<0.05),为认知障碍的影响因素。结论认知障碍的程度与Hcy浓度、左侧外宽度、侧脑室体部指数和哈氏值存在关联。

Objective To explore the correlation between cognitive impairment and plasma levels of homocysteine（Hcy）,the indexes of brain atrophy. Methods The surveyed individuals were divided into severe AD group,moderate AD group,mild AD group,MCI group,and normal control group.Plasma homocysteine（Hcy） levels,Huckmam＇s values,index of somatic part of lateral ventricle, interuncal distance,width of left and right lateral fissure,and extend of the third ventricle in the five groups were examined.The relationships between Hcy levels and MMSE score in the five groups were analyzed with Spearman correlation analysis. Results The plasma Hcy levels were increased with the increasing degree of cognitive impairment.Spearman correlation analysis showed that the relationships between Hcy levels and MMSE score in severe AD group,moderate AD group,mild AD group,MCI group,and normal control group were r=-0.365,r=-0.389,r=-0.433,r=-0.424,and r=-0.412,respectively.There was a significant negative correlation between MMSE score and interuncal distance,width of left and right lateral fissure,extend of the third ventricle,Huckmam＇s values（r=-0.457,r=-0.629,r=-0.636,r=-0.701,r=-0.533）.There was a significant positive correlation between index of somatic part of lateral ventricle and MMSE score （r=0.654）.Logistic regression model results showed that there were statistically significant differences in Hcy concentration,width of left lateral fissure, index of somatic part of lateral ventricle,Huckmam＇s values among the five groups（P0.05）,which were the influencing factors of cognitive impairment. Conclusions The degree of cognitive impairment is correlated with plasma Hcy concentration,width of left lateral fissure,index of somatic part of lateral ventricle,and Huckmam＇s values.