高同型半胱氨酸血症与老年人认知功能障碍相关性研究

Correlation of high homocysteine and cognitive dysfunction in elderly patients

目的通过对秦皇岛市部分地区老年人认知功能障碍的发生情况的调查,分析高同型半胱氨酸血症(homocysteine,Hcy)是否为老年人认知功能障碍的独立危险因素;并分析高Hcy血症与认知功能障碍程度之间的相关性。方法以秦皇岛市部分地区进行大规模流行病学调查1 010例老年人中筛查出的认知功能障碍患者112例,其中轻度认知障碍组67例,痴呆组45例;以流行病调查结果认知功能正常人群898例中随机选取100例为对照组。对影响认知功能的可能危险因素血同型半胱氨酸以及年龄、受教育程度、吸烟史、饮酒史、高血压、血糖、血脂等引入非条件Logistic回归分析,判断高同型半胱氨酸血症是否为认知功能障碍的独立危险因素;并对轻度认知功能障碍患者及痴呆患者和认知功能正常对照组三者间血浆同型半胱氨酸含量进行比较。结果通过非条件logistic回归分析,矫正了年龄、文化程度、吸烟、饮酒、高血压、血糖、血脂等因素,得出高Hcy血症是认知功能障碍的独立危险因素;且认知障碍程度与Hcy含量相关。轻度认知功能障碍组Hcy(20.03±9.02)μmol/L;痴呆组Hcy(26.11±13.29)μmol/L;痴呆组及轻度认知障碍组Hcy均高于老年正常对照组(16.34±6.76)μmol/L,差异有统计学意义(P<0.05)。结论高Hcy是老年人认知功能障碍的危险因素,且认知障碍程度与Hcy含量高低相关。

Objective To prove the high homocysteine is the risk factor of cognitive dysfunction,and to analyze the correlation of high homocysteine level and cognitive dysfunction degree of the elderly patients.Methods A large-scale epidemiological survey of cognitive dysfunction screening was conducted among the parts of the senior citizens in Qinhuangdao,which involved 1 010 cases of elderly patients.Among them,112 cognitive dysfunction patients were cataloged as the case group,which included 67 mild cognitive impairment patients cataloged as the mild cognitive impairment and 45 dementia patients cataloged as the dementia group,and 100 individuals which were selected randomly from the remained 898 cases as control group.The conceivable risk factors which may affect patients＇ cognitive function included age,education,smoking history,alcohol abuse,hypertension,blood glucose,blood lipids and others.We inserted those conceivable factors to a non-conditional logistic regression analysis to prove that the homocysteine was the eventual independent risk factor of cognitive dysfunction.Besides,comparison was made in homocysteine for the further study among mild cognitive dysfunction patients,dementia patients and the normal individuals.Results Through multiple regression analysis,we redressed the influence caused by age,education,smoking,alcohol,hypertension,blood sugar and blood lipids.So,it cames to the decision that high homocysteine was a risk factor to cognitive dysfunction and it was confirmed that high homocysteine level significantly correlated to the degree of cognitive dysfunction（P0.05）.Mild cognitive impairment group：Hcy（20.03±9.02） μmol/L;dementia group：Hcy（26.11±13.29） μmol/L;The Hcy of dementia and mild cognitive impairment group was higher than that of the elderly normal control group（16.34±6.76） μmol/L,and the difference was statistically significant（P0.05）.Conclusion High homocysteine is the risk factor of cognitive dysfunction of the elderly,and its level of both sides is significantly correlated with the degree of cognitive dysfunction.