阿尔茨海默病患者痴呆程度与血浆同型半胱氨酸水平的研究

The correlation between the degree of dementia with Alzheimer＇s disease patients and plasma homocysteine levels

目的 研究阿尔茨海默病（AD）患者痴呆程度与血浆同型半胱氨酸（Hcy）水平的关系.方法 依据美国国立神经病语言障碍卒中研究所和阿尔茨海默病及相关疾病学会（NINCDS-ADRDA）诊断标准及Hachinski缺血量表,筛选我科门诊及住院AD患者45例,及健康对照组15例,分别进行MMSE量表评分,分为轻度痴呆组、中度痴呆组、重度痴呆组和健康对照组,每组15例,监测患者血浆Hcy浓度进行对比分析.结果 AD组患者血浆Hcy浓度较健康对照组明显增高;其中轻度痴呆组血浆Hcy浓度较中度痴呆组和重度痴呆组降低,各AD组患者与健康对照组相比较,中、重度痴呆组与轻度痴呆组相比较均具有统计学意义（P＜0.05）;MMSE量表评分与Hcy水平呈负相关（r=-0.843,P＜0.05）.结论 血浆Hcy水平是阿尔茨海默病的独立高危因素,与AD患者的痴呆程度密切相关.

Objective To investigate the relationship between the degree of dementia in Alzheimer＇s disease patients and plasma homocysteine （Hcy） levels. Methods According to the diagnostic criteria of NINCDS - ADRDA （National Institute of Neurological and Communicative Disorder and Stroke/Alzheimer＇s Disease （AD） and Related Disorders Association） and Hachinski Ischemia Scale, 45 AD patients admitted to our hospital and 15 health subjects were selected. According to the scores of mini -mental state examination （MMSE）, the AD subjects were divided into a mild dementia group, a moderate dementia group and a sever dementia group and detected their plasma homocysteine levels. Results AD Patients produced higher concentrations of plasma homocysteine than the control （P 〈 0.05 ）. Compared with patients with mild dementia, higher concentration of plasma homocysteine were detected in those with moderate to server dementia （ P 〈 0.05）. MMSE scores were negatively associated with plasma homocysteine levels （ r = - 0. 843, P 〈 0.05）. Conclusion An elevated homocysteine level is an independent risk factor for Alzheimer＇s disease and closely associated with the degree of dementia in AD patients.