老年痴呆患者认知功能与氧化应激、脑灌注状态的关系探究

Investigation on the correlation between cognitive function and oxidative stress,cerebral perfusion state of elderly patients with Alzheimer’s disease

目的探究与分析老年痴呆患者认知功能与氧化应激、脑灌注状态的关系。方法选取90例老年痴呆患者作为观察组,另选同期的90例健康老年人作为对照组。检测并比较两组的血清氧化应激指标[过氧化氢酶(CAT)、超氧化物岐化酶(SOD)、丙二醛(MDA)及谷胱甘肽过氧化物酶(GSH-Px)]及脑灌注状态[脑各区域(额叶、颞叶、顶叶及枕叶)的相对脑血流量(rCBF)值];比较观察组中不同临床痴呆评定量表(CDR)评分患者的血清氧化应激指标、脑灌注状态;采用Spearman秩相关分析血清氧化应激指标及脑各区域rCBF值与CDR评分的相关性。结果观察组血清MDA水平高于对照组,血清CAT、SOD、GSH-Px水平低于对照组,差异有统计学意义(P<0.05)。观察组中不同CDR评分患者的血清CAT、SOD、MDA及GSH-Px水平比较差异具有统计学意义(P<0.05);观察组中CDR评分3分患者血清MDA水平高于CDR评分1、2分患者,血清CAT、SOD、GSH-Px水平低于CDR评分1、2分患者,CDR评分2分患者血清MDA水平高于CDR评分1分患者,血清CAT、SOD、GSH-Px水平低于CDR评分1分患者,差异有统计学意义(P<0.05)。观察组额叶、颞叶、顶叶及枕叶的rCBF值低于对照组,差异有统计学意义(P<0.05)。观察组中不同CDR评分患者额叶、颞叶、顶叶及枕叶的r CBF值比较差异具有统计学意义(P<0.05);观察组中CDR评分3分患者额叶、颞叶、顶叶及枕叶的rCBF值低于CDR评分1、2分患者,CDR评分2分患者额叶、颞叶、顶叶及枕叶的rCBF值低于CDR评分1分患者,差异有统计学意义(P<0.05)。Spearman秩相关分析显示:血清MDA与CDR评分呈正相关(r=0.796,P<0.05);血清CAT、SOD、GSH-Px及额叶、颞叶、顶叶、枕叶的rCBF值与CDR评分呈负相关(r=-0.793、-0.831、-0.911、-0.923、-0.893、-0.865、-0.817,P<0.05)。结论老年痴呆患者的氧化应激及脑灌注状态相对较差,且其与认知功能有密切关系,因此在老年痴呆患者中的检测价值相对较高。

Objective To investigate and analyze the correlation between cognitive function and oxidative stress,cerebral perfusion state of elderly patients with Alzheimer’s disease.Methods 90 patients with Alzheimer’s disease were selected as the observation group,and 90 healthy elderly subjects in the same period were selected as the control group.Comparison was made on serum oxidative stress indicators[catalase(CAT),superoxide dismutase(SOD),malondialdehyde(MDA)and glutathione peroxidase(GSH-Px)]and cerebral perfusion status[relative cerebral blood flow(rCBF)values in various regions of the brain(frontal,temporal,parietal and occipital lobes)]between the two groups,and serum oxidative stress indicators,cerebral perfusion status of patients with different Clinical Dementia Rating(CDR)scores among patients in the observation group.Spearman’s rank correlation analysis was used to analyze the correlation between serum oxidative stress indexes and rCBF values in various brain regions and CDR scores.Results The serum MDA level in the observation group was higher than that in the control group,and the serum CAT,SOD and GSH-Px levels were lower than those in the control group,and the differences were statistically significant(P<0.05).The differences in serum CAT,SOD,MDA and GSH-Px levels of patients with different CDR scores in the observation group were statistically significant(P<0.05).In the observation group,the serum MDA level of patients with CDR score of 3 were higher than that of patients with CDR score of 1 and 2,the serum CAT,SOD,GSH-Px levels were lower than those of patients with CDR score of 1 and 2,the serum MDA levels of patients with CDR score of 2 were higher than those of patients with CDR score of 1,and the serum CAT,SOD,and GSH-Px levels were lower than those of patients with CDR score of 1.All the differences were statistically significant(P<0.05).The rCBF values of the frontal,temporal,parietal and occipital lobes of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).In the observation group,the rCBF values of the frontal,temporal,parietal and occipital lobes of patients with different CDR scores were significantly different(P<0.05).In the observation group,the rCBF values in the frontal,temporal,parietal and occipital lobes of patients with CDR score of 3 were lower than those of patients with CDR score of 1 and 2,and the rCBF values in the frontal,temporal,parietal and occipital lobes of patients with CDR score of 2 were lower than those of patients with CDR score of 1.All the differences were statistically significant(P<0.05).Spearman’s rank correlation analysis showed that serum MDA was positively correlated with CDR scores(r=0.796,P<0.05).Serum CAT,SOD,GSH-Px and r CBF values of frontal,temporal,parietal and occipital lobes were negatively correlated with CDR scores(r=-0.793,-0.831,-0.911,-0.923,-0.893,-0.865,-0.817;P<0.05).Conclusion The oxidative stress and cerebral perfusion state of elderly patients with Alzheimer’s disease are relatively worse,and they have close correlation to the cognitive function,so the detection value in these elderly patients with alzheimer’s disease are relatively high.