老年痴呆患者脂糖代谢指标及血清CRP、IL-6和TNF-α的表达及临床意义

The Expression and Clinical Significance of Lipid and Glucose Metabolic Indexes, the Levels of Serum CRP, IL-6 and TNF-α in Patients with Senile Dementia

目的:检测老年痴呆患者体内的脂糖代谢指标及C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)的表达水平,并分析其临床意义。方法:选取2014年2月至2016年4月成都市第五人民医院神经内科收治的61例老年痴呆患者,其中阿尔茨海默病(AD)患者32例(AD组)、血管性痴呆(VD)患者29例(VD组),另选取30例健康体检者作为对照组,对比三组受试者的脂糖代谢指标胰岛素降解酶(IDE)、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及炎症因子CRP、IL-6、TNF-α的水平,统计并比较各组基础疾病情况。结果:AD组及VD组的FPG、TC、TG及LDL-C水平均高于对照组,而IDE、HDL-C低于对照组,差异均具有统计学意义(P<0.05);AD组及VD组患者血清CRP、IL-6、TNF-α水平均高于对照组,且VD组高于AD组,差异均具有统计学意义(P<0.05);VD组高血压、糖尿病、冠心病发病率明显高于AD组和对照组(P<0.05),AD组和VD组高血脂发病率比较差异无统计学意义(P>0.05),但与对照组比较明显升高(P<0.05)。结论:糖脂代谢异常及CRP、IL-6、TNF-α均参与AD与VD的发生发展过程,调节血糖、血脂及进行抗炎治疗有助于对老年痴呆患者进行早期干预和治疗。

Objective:Detection of the lipid and glucose metabolic indexes,the levels of serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)in patients with Alzheimer's disease(AD)and vascular dementia(VD)and analyze its clinical significance.Methods:61 patients with senile dementia admitted to neurology department of Chengdu Fifth People's Hospital from February 2014 to April 2016 were selected as the subjects of study,there were 32 patients with Alzheimer's disease(AD group)and 29 patients with vascular dementia(VD group),and another 30 healthy persons were selected as control group.The levels of lipid and glucose metabolic indexes insulin degrading enzyme(IDE),fasting insulin(FINS),fasting blood glucose(FPG),insulin resistance index(HOMA-IR),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and inflammatory factors serum CRP,IL-6 and TNF-αwere compared among the three groups.The basic diseases in each group were statisfied and compared.Results:The levels of FPG,TC,TG and LDL-C in AD group and VD group were higher than those in control group,while the levels of IDE and HDL-C were lower than those in control group,the differences had statistical significance(P<0.05).The levels of serum CRP,IL-6 and TNF-αin AD group and VD group were higher than those in control group,and those in VD group were higher than those in AD group(P<0.05).The incidence of hypertension,diabetes and coronary heart disease in VD group was significantly higher than that in AD group and control group(P<0.05).There was no significant difference in the incidence of hyperlipidemia between AD group and VD group(P>0.05),but it was significantly increased compared with control group(P<0.05).Conclusion: Abnormal glucose and lipid metabolism and CRP, IL-6, TNF-α are all involved in the occurrence and development of AD and VD.Regulating blood sugar, lipid and anti-inflammatory therapy are helpful for early intervention and treatment of senile dementia patients.