老年缺血性脑卒中患者认知功能障碍与血清同型半胱氨酸的关系

Relationship between Cognitive Dysfunction in Elderly Patients with Ischemic Stroke and Serum Homocysteine

目的本研究旨在探讨老年缺血性脑卒中伴有认知功能障碍患者的血清同型半胱氨酸(Hcy)、部分代谢指标的水平及与认知功能的关系。方法 120例确诊的老年缺血性脑卒中患者依据蒙特利尔评估量表(Mo CA)、日常生活活动能力(ADL)量表评价结果分为认知功能正常组57例、认知功能障碍组63例,年龄性别相匹配的60例健康对象作为健康组,分别比较3组研究对象的Hcy及部分代谢指标的差异,并分析Hcy及部分代谢指标与认知功能评分的关系。结果认知功能正常组、认知功能障碍组的Hcy分别为14.15±2.88、23.44±4.09μmol/L,显著高于健康组的10.57±2.16μmol/L(P<0.05),认知功能正常组、认知功能障碍组的高密度脂蛋白(LDL-C)分别为0.99±0.12、0.95±0.14mmol/L,显著低于健康组的1.24±0.21mmol/L(P<0.05)。3组研究对象的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、肌酐(Cr)、空腹血糖值(FBG)、尿素氮(BUN)值差异无统计学意义(P>0.05)。认知功能障碍组的Mo CA总评分、视空间与执行能力、注意力与计算能力、抽象能力评分与Hcy值呈显著负相关(P<0.05);Mo CA总评分、视空间与执行能力、注意力与计算能力评分与HDL-C值呈显著的正相关(P<0.05)。结论对于老年脑卒中患者,Hcy、HDL-C水平与患者的认知功能障碍具有一定的相关性,早期监测Hcy、HDL-C具有重要意义。

Objective To discuss the relationship between cognitive dysfunction and serum homocysteine （Hcy）, metabolic level such as the low density lipoprotein. Methods Totally 120 cases of ischemic stroke patients were devided into three groups by Montreal Assessment Scale （MoCA）, daily living activity capacity （ADL）, with 57 cases of normal group, 63 cases of cognitive dysfunction group and 60 healthy subjects were compared. Results Normal cognitive function and cognitive dysfunction group of Hcy were 14.15± 2.88, 23.44± 4. 091xmol/L,which were significantly higher than the healthy group 10.57± 2.16μmol/L （P 〈 0.05 ）. Normal cognitive function, cognitive dysfunction group of high - density lipoprotein （ LDL - C） were 0.99 ±0.12, 0.95 ±0.14mmol/L,which were significant- ly lower than the healthy group 1.24 ± 0.21mmol/L （P 〈 O. 05 ）. Total cholesterol, the study of the three groups （TC）, triglyceride （TG）, low density lipoprotein （LDL- C）, creatinine （Cr）, fasting blood glucose level （FBG） , the value of urea nitrogen （BUN） were not significant different from others （P 〉 0.05 ）. In cognitive dysfunction group, MoCA total score, depending on the space and implemen- tation capacity, attention and calculation capability, the ability to score and Hcy abstract value were significantly negatively correlated （P 〈 0.05） ; MoCA total score, depending on the space and implementation capacity, attention force and computing power ratings and HDL - C values were significantly positive correlation （P 〈 0.05）. Conclusion For elderly patients with cerebral stroke, HDL - C and Hcy levels show certain relationship with cognitive dysfunction. The monitoring of HDL - C and Hcy has clinical importance.