血清同型半胱氨酸与癫痫患者认知功能损害的关系研究

Relationship between Serum Homocysteine and Cognitive Impairment in Patients with Epilepsy

目的:探究血清同型半胱氨酸与癫痫患者认知功能损害的关系。方法:选取2016年1月-2018年1月在本院进行治疗的癫痫患者135例作为研究对象,采用阿尔茨海默病联合会制定的认知功能损伤标准并根据其是否存在损伤将其分为损伤组(n=61)和非损伤组(n=74)。观察比较两组的生物指标水平,包括血清同型半胱氨酸(Hcy)、叶酸、维生素B12,MMSE评分情况及患者的Hcy水平与MMSE评分之间的相关性。结果:损伤组Hcy水平为(21.12±5.58)μmol/L明显高于非损伤组的(12.49±5.17)μmol/L,而叶酸及维生素B12水平分别为(12.33±2.68)μg/L及(386.61±123.40)ng/L均明显低于非损伤组的(17.52±3.52)μg/L及(665.25±234.25)ng/L,差异均有统计学意义(P<0.05)。损伤组各项MMSE评分及总分情况均明显低于非损伤组,差异均有统计学意义(P<0.05)。当Hcy水平为15.0～20.0μmol/L或>20.0μmol/L时,其Hcy水平与MMSE评分均呈负相关(r=-0.360 0、-0.460 0,P=0.001 5、0.002 7)。结论:Hcy水平与患者神经损伤程度在一定条件下呈负相关关系,针对癫痫患者,临床能够通过对其Hcy水平进行检测,在一定程度上协助判断患者认知功能损害程度,以便及时采取相应干预措施,提高患者生活质量。

Objective:To explore the relationship between serum homocysteine and cognitive impairment in patients with epilepsy.Method:A total of 135 patients with epilepsy treated in our hospital from January 2016 to January 2018 were selected as the study objects.The cognitive impairment criteria formulated by the Alzheimer’s Disease Federation were used and according to whether there were impairments,they were divided into injury group(n=61)and non-injury group(n=74).The levels of serum homocysteine(Hcy),folic acid,vitamin B12,MMSE score and the correlation between Hcy level and MMSE score between the two groups were observed and compared.Result:The level of Hcy in the injury group was(21.12±5.58)μmol/L,which was significantly higher than(12.49±5.17)μmol/L in the non-injury group;the levels of folic acid and vitamin B12 were(12.33±2.68)μg/L and(386.61±123.40)ng/L,which were significantly lower than(17.52±3.52)μg/L and(665.25±234.25)ng/L respectively in the non-injury group,the differences were statistically significant(P<0.05).The MMSE scores and total scores of the injury group were significantly lower than those of the non-injury group,the differences were statistically significant(P<0.05).When Hcy was 15.0-20.0μmol/L or>20.0μmol/L,Hcy levels were negatively correlated with MMSE scores(r=-0.360 0,-0.460 0,P=0.001 5,0.002 7).Conclusion:The level of Hcy is negatively correlated with the degree of nerve damage of patients under certain conditions.Therefore,for patients with epilepsy,the level of Hcy can be detected clinically to help judge the degree of cognitive impairment,so as to take timely intervention measures to improve the quality of life of patients.