血浆HCY、hs-CRP水平与男性酒精依赖患者认知功能的关系

Relationship between plasma HCY,hs-CRP levels and cognitive function in male patients with alcohol dependence

目的研究血浆同型半胱氨酸(HCY)、超敏C反应蛋白(hs-CRP)水平与男性酒精依赖患者认知功能的关系。方法选择2015年6月-2017年1月在湖南省脑科医院诊治的酒精依赖性患者106例纳入本次研究,记为观察组。另选同期在医院实施体检的健康志愿者100例记为对照组,检测并对比两组临床指标、认知功能,比较不同HCY和hs-CRP水平的观察组患者临床指标,分析观察组患者血浆HCY和hs-CRP水平,及红细胞参数与其认知功能的相关性。结果观察组的内皮依赖型舒张功能(FMD)和红细胞计数水平均低于对照组,HCY、hs-CRP及平均红细胞体积均高于对照组,差异均有统计学意义(均P<0.05)。观察组的即刻记忆和视觉空间,及语言功能和注意,以及延迟记忆和重复性成套型神经心理状态检测量表(RBANS)总分均明显低于对照组,差异均有统计学意义(均P<0.05)。酒精依赖性患者中高HCY组的红细胞计数及认知功能各项评分均明显低于正常HCY组,平均红细胞体积则明显高于正常HCY组,差异均有统计学意义(均P<0.05)。高hs-CRP组的红细胞计数及认知功能各项评分均明显低于正常hs-CRP组,平均红细胞体积则明显高于正常hs-CRP组,差异均有统计学意义(均P<0.05)。观察组患者的血浆HCY和hs-CRP水平均与其认知功能各项评分呈负相关,患者的红细胞计数与其认知功能中的延迟记忆呈正相关,而平均红细胞体积则与其语言功能和延迟记忆,以及RBANS总分均呈负相关。结论血浆HCY、hs-CRP水平与男性的酒精依赖患者的认知功能联系紧密,且红细胞相关参数及血管内皮的病变均可能参与到认知功能的损害过程中,值得给予监测关注。

Objective To study the relationship between plasma homocysteine （HCY）, high sensitive C reactive protein （hs-CRP） and cognitive function in male patients with alcohol dependence. Methods One hundred and six alcohol dependence patients hospitalized in Brain Hospital of Hunan Province from June, 2015 to January, 2017 were selected as the observation group, and 100 healthy volunteers who underwent physical examination in the hospitalin the same period served as the control group. The clinical indicators and cognitive function of the two groups were detected and compared. The clinical indicators of patients with different levels ofhs-CRP and HCY in the observation group were compared, and then the correlation between cognitive function and plasma HCY, hs-CRP levels, erythrocyte parameters in patients of the observation group was analyzed. Results The endothelium dependent diastolic function （FMD） and red cell counts were both lower in the observation group than in the control group, while plasma HCY, hs-CRP levels and mean corpuscular volume （MCV） were all higher in the observation group than in the control group, showing statistically significant differences （all P〈0.05）. The immediate memory and visual space, language function and attention, delayed memory and the total score of Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） were all significantly lower in the observation group than in the control group, and the differences showed statistically significant （all P〈0.05）. Among the patients with alcohol dependence, red blood cell count and score of each dimension of cognitive function in the high HCY group were all significantly lower than those of the normal HCY group, but MCV was significantly higher than that of the normal HCY group, with statitsically significant differences （all P〈0.05）. Red blood cell count and score of each dimension of cognitive function in the high hs-CRP group were all significantly lower than those of the normal hs-CRP group, while MCV was significantly higher than that of the normal HCY group, showing statitsically significant differences （all P〈0.05）. Plasma HCY and hs-CRP levels were both negatively correlated with score of each dimension of cognitive function in patients of the observation group. There was a positive correlation between red blood cell count and delayed memory of cognitive function in patients of the observation group, but a negative correlation between MCV and language function, delayed memory, the total score of RBANS. Conclusions Plasma HCY and hs-CRP levels are closely related to cognitive function of male patients with alcohol dependence; moreover, red blood cell parameters and vascular endothelial lesions may be both involved in the process of impairment of cognitive function, which are worthy of being monitored and concerned.