血清同型半胱氨酸、叶酸及维生素B12与老年血管性痴呆的相关性研究

Study on the correlation between plasma homocysteine, folate acid and vitamin B12 levels and vascular de-mentia

目的探讨血清同型半胱氨酸（Hcy）、叶酸（FA）及维生素B12（VitB12）与老年血管性痴呆（VD）的相关性。方法检测96例VD患者、152例脑梗死非痴呆患者及80例健康对照者Hcy、FA、VitB12水平并分析其变化；按MMSE评分标准评估VD患者的认知功能，按痴呆程度将其分为重度、中度及轻度三组，并检测各组血清Hey浓度，分析Hcy水平与痴呆程度的关系。结果VD组及脑梗死非痴呆组血清Hcy水平均显著高于对照组（t=3．26、3．14，均P〈0．01），其中以VD组最高；VD组及脑梗死非痴呆组血清FA及VitBl2水平均显著低于对照组（t=3．16、2．98、3．21、2．91，均P〈0．01），其中以VD组最低。VD患者血清Hcy水平随痴呆程度的加重而升高，Hcy浓度与MMSE评分呈负相关（r=-0．69，P〈0．05）。结论高Hcy血症与VD具有相关性，高Hcy血症可能是导致VD发生的危险因素之一；FA及VitB，2缺乏可引起Hcy的增高，FA及VitBl2缺乏可能是导致VD发生的间接因素。

Objective To study on the correlation between plasma homocysteine （Hcy）, folate acid（FA） and vitamin B12 （VitB12） levels and vascular dementia （VD）. Methods To measure plasma Hcy, FA and vitamin B12 in 96 patients with VD,in 152 non-dementia cerebrovascular disease （ NDCVD ） and in 80 normal controls re- spectively, and results werw compared between each two groups by using student test. Cognitive status was evaluar by using mini mentai state examination （MMSE）. The effect of Hcy, FA and VitBn on VD and its cognitive function were analyzed. Results The levels of plasma Hcy in VD and NDCVD were higher than those in normal control grop, and there was significantly difference （t = 3.26,3.14, all P 〈 O. 01 ） , and the best high one is VD;The levels of plasma FA and VitBn in VD and NDCVD were lower than those in normal control grop, and there was significantly difference（ t = 3.16,2.98,3.21,2.91 ,all P 〈0.01 ） ,and the best low one is VD. The levels of plasma Hcy concentrations were in- creased and MMSE scores were decreased with severity of dementia, and there were negative correlation between MMSE scores and plasma Hcy concentrations （ r = - 0.69,P 〈 0.05 ）. Conclusion The levels of plasma Hcy corre- lated with VD. High-Hcy is one of possible rise factor for VD in senior. Both low-FA and low-VitB^z were indirect fac- tors for VD.