TBIL、Lp-PLA2、Hcy水平与癫痫患者认知功能障碍的相关性研究

Correlation between serum TBIL,Lp-PLA2 and Hcy levels and cognitive impairment in patients with epilepsy

目的:探讨血清总胆红素(TBIL)、脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)水平与癫痫患者认知功能障碍的相关性。方法:选取196例癫痫患者为研究对象,依据是否存在认知功能障碍分为认知正常组(n=121)与认知障碍组(n=75)。比较两组患者TBIL、Lp-PLA2及Hcy水平,分析癫痫患者认知功能障碍相关影响因素及TBIL、Lp-PLA2和Hcy与蒙特利尔认知评估(MoCA)量表评分的相关性。结果:两组患者病程、发作频率比较,差异有统计学意义(P<0.05);认知障碍组患者TBIL水平低于认知正常组(P<0.05),Lp-PLA2、Hcy水平高于认知正常组(P<0.05);病程、发作频率、Lp-PLA2、Hcy为认知功能障碍的独立危险因素(P<0.05),TBIL为认知功能障碍保护因素(P<0.05);血清TBIL与MoCA评分呈正相关(P<0.05),Lp-PLA2、Hcy与MoCA评分呈负相关(P<0.05)。结论:血清TBIL、Lp-PLA2、Hcy均为癫痫患者发生认知功能障碍的独立影响因素,TBIL水平越低,Lp-PLA2与Hcy水平越高,患者认知功能越差。

Objective:To analyze the correlation between serum total bilirubin(TBIL),plasma lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)levels and cognitive impairment in patients with epilepsy.Methods:196 patients with epilepsy were selected as the research objects,and they were divided into normal cognition group(n=121)and cognitive impairment group(n=75)according to whether there was cognitive impairment.The levels of serum TBIl,Lp-PLA2 and Hcy were compared.The related influencing factors of cognitive impairment in patients with epilepsy,and the correlation between TBIl,Lp-PLA2,Hcy and Montreal Cognitive Assessment(MoCA)score were analyzed.Results:There were statistically significant differences between the two groups in the course of disease and seizure frequency(P<0.05).Serum TBIl level in the cognitive impairment group was significantly lower than that in the normal cognition group(P<0.05),and the levels of Lp-PLA2 and Hcy were significantly higher than those in the normal cognition group(P<0.05).The course of disease,seizure frequency,Lp-PLA2 and Hcy were independent risk factors for cognitive impairment(P<0.05),while TBil was a protective factor(P<0.05).Serum TBIl was positively correlated with MoCA score(P<0.05),and Lp-PLA2 and Hcy were negatively correlated with MoCA score(P<0.05).Conclusion:Serum TBIl,Lp-PLA2 and Hcy are independent factors influencing the development of cognitive impairment in patients with epilepsy.The lower the TBIl level,the higher the Lp-PLA2 and Hcy levels,the worse the cognitive function.