血清同型半胱氨酸、叶酸浓度水平与老年阿尔茨海默病发病的相关性研究

Correlation between serum homocysteine,folate levels and the incidence of Alzheimer's disease in the elderly

目的研究血清同型半胱氨酸(Hcy)、叶酸浓度水平与老年阿尔茨海默病(AD)发病的相关性,以期为临床防治提供指导。方法将2016年5月-2018年10月于本院接受诊治的92例老年阿尔茨海默病患者作为研究组,另选择同期于本院健康体检者80例为对照组。选择高效液相法对2组人员的血清Hcy表达水平进行测定,并应用化学发光法对血清叶酸水平进行检测;分析血清Hcy、叶酸与AD患者认知功能、生活质量的相关性。结果研究组患者的血清Hcy水平高于对照组,但血清叶酸水平、MMSE评分均低于对照组,差异有统计学意义(P<0.05);研究组患者的血清Hcy过高表达检出率、叶酸过低表达检出率均高于对照组,差异有统计学意义(P<0.05);AD过高Hcy组患者的血清叶酸水平显著低于AD正常Hcy组,差异有统计学意义(P<0.05);经Spearman相关性分析发现,血清叶酸和认知功能、生活质量显示为正相关(r=0.328、r=0.339,P<0.05),而血清Hcy和认知功能、生活质量显示为负相关(r=-0.517、r=-0.502,P<0.05)。结论血清同型半胱氨酸过高表达和老年阿尔茨海默病发病存在直接相关性,即高Hcy血症可能是引发AD的独立危险因素;而人体缺乏叶酸能导致血清Hcy表达升高,故认为叶酸的缺乏可能是引发AD的间接危险因素。

Objective To study the correlation between serum homocysteine(Hcy),folic acid concentration and the pathogenesis of Alzheimer's disease(AD)in the elderly,in order to provide guidance for clinical prevention and treatment.Methods Ninety-two cases of elderly Alzheimer's patients who were treated in our hospital from May 2016 to October 2018 were enrolled as the study group.Another 80 normal people for physical examination were selected as the control group at the same time.The serum Hcy levels of the two groups were determined by high performance liquid phase method,and the serum folate level was detected by chemiluminescence method.The correlation between serum Hcy,folic acid and cognitive function and life quality of AD patients was analyzed.Results The serum Hcy level of the study group was higher than that of the control group,but the serum folate level and MMSE score were lower than the control group(P<0.05).The detection rate of serum Hcy overexpression and the detection rate of folic acid hypoplasia were higher in the study group than that in the control group(P<0.05).The serum folate level of patients with AD hyper-Hcy group was significantly lower than that of AD normal Hcy group(P<0.05).According to Spearman correlation analysis,serum folic acid showed positive correlation with cognitive function and quality of life(r=0.328,r=0.339,P<0.05).Serum Hcy showed a negative correlation with cognitive function and quality of life(r=-0.517,r=-0.502,P<0.05).Conclusion There is a direct correlation between the high level of serum homocysteine and the pathogenesis of Alzheimer's disease in the elderly.High Hcyemia may be an independent risk factor for AD.However,the lack of folic acid in the human body can lead to an increase in serum Hcy level.It is believed that the lack of folic acid may be an indirect risk factor for triggering AD.