皮质下缺血性血管病患者认知功能与血浆同型半胱氨酸水平的相关性

The relationship between cognitive function and plasma homocysteine level in patients with subcortical ischemic vascular disease

目的探讨皮质下缺血性血管病(SIVD)患者认知功能与患者血浆同型半胱氨酸(Hcy)水平关系。方法收集130例SIVD患者(SIVD组),依据认知损害程度分为皮质下血管性轻度认知损害组(SVMCI组)及皮质下血管性痴呆组(SVaD组),另选取60例认知功能正常老年人作为对照组(正常对照组)。采用MMSE、蒙特利尔认知测评量表(MoCA)及临床痴呆量表(CDR)评价分别对两组患者进行痴呆程度测定。分别测定两组患者的Hcy浓度。然后,对指标进行比较和相关分析。结果SIVD组受检者血Hcy水平显著高于对照组(P<0.05),其血清叶酸及维生素B12水平均显著低于对照组(P<0.05),SIVD组受检者血Hcy水平随着痴呆程度增加而显著升高(P<0.05)。SIVD组患者的血浆Hcy水平与自身痴呆程度呈正相关(P<0.05),与MMSE及MoCA评分呈正相关(P<0.05)。结论高水平Hcy与SIVD的发生、发展相关,高Hcy血症是SIVD发病的一个重要因素。

Objective To investigate the relationship between cognitive function and plasma homocysteine(Hcy)level in patients with subcortical ischemic vascular disease(SIVD).Methods Data of SIVD patients were collected(n=130),and these patients were divided into the SVMCI group(n=72)and the SVAD group(n=58).And 60 people with normal cognitive function were selected as the control group(n=60).MMSE,MoCA and CDR were used to evaluate the degree of dementia in the two patient groups.Indicators were compared and analyzed.Results The Hcy concentration in the SIVD group was significantly higher than that in the control group(P<0.05),and the plasma Hcy level in the SIVD group increased significantly with the increase of dementia degree(P<0.05).In the SIVD group,Hcy level was positively correlated with the degree of dementia(P<0.05),MMSE and MOCA score(P<0.05).Conclusion High levels of hcy are associated with the pathogenesis of SIVD,and hyperhcyemia is an important factor in the pathogenesis of SIVD.