不同程度阿尔茨海默病患者血脂水平的研究

A study of serum lipid levels in patients with different degrees of Alzheimer’s disease

目的对不同程度首次接受药物治疗前的阿尔茨海默病(Alzhemer disease,AD)患者血脂水平[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、血清高密度脂蛋白(serum high-density lipoprotein,HDL)、血清低密度脂蛋白(serum low-density lipoprotein,LDL)]进行研究。方法选取2018年1月—2019年9月我院首次收治入院并接受药物治疗前的AD患者128例(观察组)和健康体检者84例(对照组)作为研究对象。将观察组按照CDR评分,分为轻度AD组(CDR=1)、中度AD组(CDR=2)、重度AD组(CDR=3)。采用全自动生化分析仪检测所有研究对象血脂水平。结果观察组与对照组研究对象2组性别构成(χ^2=0.716,P=0.398)、年龄(t=0.117,P=0.907)比较,差异无统计学意义(P>0.05)。与对照组比较,重度AD组患者的TG水平低于对照组(Z=2.598,P=0.009);轻中重度AD组患者TC水平均高于对照组(LSD-t=5.185,3.837,3.701,均P<0.001);中度AD组患者HDL水平低于对照组(LSD-t=3.997,P<0.001)差异均有统计学意义。轻中重组组间比较,轻度AD患者TG水平高于重度患者(Z=2.633,P=0.008),HDL水平高于中度患者(LSD-t=2.450,P=0.015);中度AD患者HDL水平低于重度患者(LSD-t=2.288,P=0.023)。血脂水平与简易智力状态检查量表(Mini-mental State Examination,MMSE)分值之间的相关性分析显示TG与MMSE分值呈正相关(r=0.287,P=0.001)。结论未经药物治疗的AD患者的TC及HDL水平与正常人存在差异,证实AD疾病本身会影响部分血脂水平,而中重度AD患者尤为明显。AD患者随着认知功能减退,TG水平随之下降,但与正常人比较无明显差异。

Objective To study the blood lipid level[total cholesterol(TC),triglyceride(TG),serum high-density lipoprotein(HDL)and serum low-density lipoprotein(LDL)]of Alzheimer’s disease(AD)patients before different degrees of drug treatment for the first time.Methods A total of 128 cases of AD patients(observation group)and 84 cases of healthy persons(control group)who were admitted to our hospital for the first time from January 2018 to September 2019 were selected as the research objects.According to the CDR score,the observation group was divided into mild AD group(CDR=1),moderate AD group(CDR=2)and severe AD group(CDR=3).The blood lipid levels of all subjects were detected by automatic biochemical analyzer.Results There was no significant difference in gender composition(χ^2=0.716,P=0.398)and age(t=0.117,P=0.907)between the two groups(P>0.05).The TG level in the severe AD group was lower than that in the control group(Z=2.598,P=0.009).The TC level in the mild,moderate and severe AD group was higher than that in the control group(LSD-t=5.185,3.837,3.701,all P<0.001).The HDL level in the moderate AD group was lower than that in the control group(LSD-t=3.997,P<0.001).The TG level in the mild AD patients was higher than that in the severe AD patients(Z=2.633,P=0.008),the HDL level was higher in the moderate AD patients(LSD-t=2.450,P=0.015),and the HDL level in patients with moderate AD was lower than that in patients with severe AD(LSD-t=2.288,P=0.023).The correlation analysis between blood lipid level and mini mental state examination(MMSE)score showed that TG was positively correlated with MMSE score(r=0.287,P=0.001).Conclusion The levels of TC and HDL in AD patients without drug treatment are different from those of normal people.It is confirmed that AD disease itself can affect some blood lipid levels,especially in moderate and severe AD patients.With the decline of cognitive function,the level of TG in AD patients decreased,but there was no significant difference between AD patients and normal people.