Hhcy对脑小血管病患者认知功能的影响

Influence of homocysteine on cognitive function in patients with cerebral small vessel disease

目的探讨高同型半胱氨酸血症(Hhcy)对脑小血管病(SVD)患者认知功能的影响。方法 142例SVD患者根据认知功能分为痴呆组、认知功能障碍非痴呆组、认知功能正常组,测定研究对象血浆同型半胱氨酸(Hcy)水平及MMSE、画钟测验评分。结果 (1)Hcy水平痴呆组明显高于认知功能障碍非痴呆组(P<0.05),认知功能障碍非痴呆组高于认知功能正常组。(2)Logistic回归分析得出Hcy水平升高是小血管病患者认知功能损害的独立危险因素。(3)Hhcy对MMSE总评分、定向功能、语言功能以及反应视空间功能、动作的计划性和执行功能画钟测验均有独立的危险性,其OR值分别为1.044、1.057、1.040、1.251。结论 Hcy水平升高是脑小血管病认知功能损伤的独立危险因素,对总体认知功能、定向功能、语言功能以及视空间功能、动作的计划性和执行功能有独立影响作用。

Objective To investigate the influence of homocysteine on cognitive function in patients with cerebral small vessel disease.Methods One hundred and forty-two patients with cerebral small vessel disease were divided into three groups： dementia group,cognitive impairment no dementia group and cognitive normal group.Plasma Hcy was measured,and MMSE scores and clock drawing interpretation scale were assessed.Results Hcy levels in dementia group were significantly higher than cognitive impairment no dementia group,and Hcy levels in cognitive impairment no dementia group were significantly higher than cognitive normal group.Logistic regression confirmed elevated Hcy level was risk factor for cognitive impairment.For MMSE total score,orientation,language,visual-spatial,executive,odds ratios were 1.044,1.057,1.040 and 1.251,respectively.Conclusion Elevated Hcy level is an independent risk factor for cognitive function impairment and orientation,language and visual-spatial and executive function impairment.But not independent with short-term memory and attention and calculation.