同型半胱氨酸表达与老年痴呆患者病情程度及预后的相关性研究

Relativity Study on Expression of Homocysteine Associated with the Severity and Prognosis in Patients with Senile Dementia

目的研究同型半胱氨酸（Hcy）表达与老年痴呆患者病情程度及预后的相关性。方法将我院2012年6月～2015年10月收治的102例老年痴呆症患者纳入研究对象行回顾性分析。经简易智力状态检查量表（MMSE）测试分为轻度组34例、中度组36例、重度组32例。另随机抽取45名正常老年人作为正常对照组。以全自动生化分析仪进行血浆Hcy含量测试,比较病例组与正常对照组、不同病情程度间的Hcy差异,以Pearson相关性分析探究Hcy水平与病情程度的相关性。另根据Hcy水平将病例组分为高Hcy组（68例,〉15μmol/L）与正常Hcy组（34例,≤15μmol/L）,两组治疗后不同时间进行Barthal指数评分,探究Hcy与Barthal指数的相关性。结果轻度、中度、重度组血浆Hcy含量分别为（21.37±3.85）μmol/L、（25.14±5.26）μmol/L、（30.28±6.79）μmol/L,较正常对照组（15.76±1.44）μmol/L明显升高（P〈0.05）,血浆Hcy含量与老年痴呆症病情严重程度呈显著正相关性（r=0.42,P〈0.05）;高Hcy组治疗前后的Barthal指数均低于正常Hcy组,且治疗后1年该指数为（76.59±17.63）,明显低于正常Hcy组（85.42±14.52）（P〈0.05）,经相关性分析患者血浆Hcy含量与其一年后Barthal指数有明显负相关性（r=-0.76,P〈0.05）,即与其远期预后效果负相关。结论在老年痴呆症患者中,Hcy含量越高,病情越严重,预后效果也越差,呈现明显的相关性。

Objective： To study the expression of homocysteine（HCY） associated with the severity and prognosis in patients with senile dementia. Method：Retrospective analysis of 102 patients with senile dementia, were admitted and treated in the First People＇s Hospital of Lianyungang from June 2012 to October 2015. They were divided into three groups with the mini-mental state examination（MMSE）, mild group（34 cases）, moderate group（36 cases）, and severe group（32 cases）, in addition, normal control group（45 cases） with randomly selection. The levels of plasma homocysteine（HCY） was measured by automatic biochemical analyzer, compared the different severity of HCY in case group and normal control group. The relativity between HCY levels and severity were analyzed with Pearson. Additionally, patients were divided into high group of HCY（68 cases, 15μmol/L） and normal group of HCY（34 cases, ≤ 15μmol/L） according to HCY levels. Barthal index score was evaluated at different time points after the treatment in two groups to explore the relevance of HCY and Barthal index. Results： The levels of plasma HCY was significantly higher in mild group [（21.37±3.85） μmol/L], moderate group[（25.14±5.26） μmol/L], and severe group [（30.28±6.79） μmol/L ] than in normal control group [（15.76±1.44） μmol/L]（P〈0.05）.The levels of plasma HCY was positive in correlated with the severity（r=0.42,P〈0.05）.The Barthal index in the high group of HCY was lower than that in the normal group of HCY before and after treatment. Furthermore, after a year treatment, the Barthal（76.59 ± 17.63） was also significantly lower than in the normal group of HCY（85.42±14.52）（P〈0.05）.The levels of plasma HCY and the Barthal index a year later, were correlated negatively by correlation analysis（r=-0.76, P〈0.05）, that the negative correlation between it and the long-term effect of prognosis. Conclusions： The severity is positively associated with the increase of homocysteine levels, the worse the prognosis is, with the obviously correlation.