血清Hcy及血脂水平与老年抑郁症患者认知功能的关系研究

Study on the relationship between serum Hcy and blood lipid levels and cognitive function in elderly depression patients

目的探讨血清同型半胱氨酸(Hcy)、血脂水平与老年抑郁症患者认知功能的关系。方法回顾性分析2019年10月至2020年5月本院收治的80例老年抑郁症患者的临床资料,将出现认知功能障碍的患者作为认知功能障碍组(n=36),将未出现认知功能障碍的患者作为认知功能正常组(n=44),测定两组患者血清Hcy、血脂水平[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平,比较两组血清Hcy、血脂水平,并分析血清Hcy、血脂水平(TG、TC、HDL-C、LDL-C)与老年抑郁症患者认知功能的关系。结果认知功能障碍组血清Hcy、TG、TC、LDL-C水平高于认知功能正常组,HDL-C水平、MOCA评分低于认知功能正常组,差异有统计学意义(P<0.05);经Pearson分析,血清Hcy、TG、TC、LDL-C水平与MOCA评分呈负相关(r<0,P<0.05);HDL-C水平与MOCA评分呈正相关(r>0,P<0.05);经二元Logistic回归分析,血清Hcy、TG、TC、HDL-C、LDL-C的方程依次为Y=﹣0.201+0.690X,Y=﹣0.201+0.796X,Y=﹣0.201+1.086X,Y=﹣0.201+5.367X,Y=﹣0.201+0.583X,表明血清Hcy、TG、TC、HDL-C、LDL-C为老年抑郁症患者出现认知功能障碍的危险因素(OR>1,P<0.05)。结论血清Hcy、TG、TC、LDL-C水平越高,HDL-C水平越低时老年抑郁症患者认知功能障碍发生风险越高,故临床上针对该病患者应加强监管力度,并及时采取有效措施进行干预,降低老年抑郁症患者发生认知功能障碍的风险。

Objective To investigate the relationship between serum homocysteine(Hcy), blood lipid levels and cognitive function in elderly depression patients. Methods The clinical data of 80 elderly depression patients admitted to our hospital from October 2019 to May 2020 were retrospectively analyzed. Patients with cognitive dysfunction were regarded as the cognitive dysfunction group(n=36), and patients with cognitive dysfunction were regarded as the normal cognitive function group(n=44). The levels of serum Hcy and blood lipid [total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C)] were measured and compared between the two groups and the relationship between serum Hcy, blood lipid levels(TG, TC, HDL-C, LDL-C) and cognitive function in elderly patients with depression were analyzed. Results The levels of serum Hcy, TG, TC, and LDL-C in the cognitive dysfunction group were higher than those in the normal cognitive function group, and the HDL-C levels and MOCA score were lower than those in the normal cognitive function group, the difference was statistically significant(P<0.05);Pearson analysis showed that serum Hcy, TG, TC, LDL-C levels were negatively correlated with MOCA scores(r<0, P<0.05);HDL-C levels were positively correlated with MOCA scores(r>0, P<0.05);after binary Logistic regression analysis, the equations of serum Hcy, TG, TC, HDL-C, LDL-C were Y=﹣0.201+0.690 X, Y=﹣0.201+0.796 X, Y=﹣0.201+1.086 X, Y=﹣0.201+5.367 X, Y=﹣0.201+0.583 X, indicating that serum Hcy, TG, TC, HDL-C, LDL-C are risk factors for cognitive dysfunction in elderly depression patients(OR>1, P<0.05). Conclusion The higher the levels of serum Hcy, TG, TC and LDL-C and the lower the level of HDL-C, the higher the risk of cognitive impairment in elderly patients with depression. Therefore, clinical supervision should be strengthened for patients with this disease and timely measures should be taken. Effective measures to intervene to reduce the risk of cognitive dysfunction in elderly depression patients.