血清Hcy水平与阿尔茨海默病患者认知功能障碍的相关性

Correlation between Serum Hcy Level and Cognitive Dysfunction in Patients with Alzheimer’s Disease

目的:分析血清同型半胱氨酸(Hcy)水平与阿尔茨海默病(AD)患者认知功能障碍之间的关系。方法:对九江市第五人民医院2021年1-7月收治的78例AD患者进行前瞻性研究,于住院时检测血清Hcy水平,并采用简易精神状态检查量表(MMSE)评估AD患者认知功能障碍严重程度并进行分组,比较轻度认知功能障碍组和中重度认知功能障碍组患者不同基线资料及血清Hcy水平,分析血清Hcy水平与AD患者认知功能障碍的相关性。结果:本次共发放78份调查问卷,收回问卷78份,剔除2份作答时间过短或答案前后矛盾的无效问卷后,有效问卷有76份,有效回收率97.44%。最终纳入的76例患者,经MMSE评分评估,轻度认知功能障碍29例,占比38.16%;中重度认知功能障碍47例,占比61.84%;中重度认知功能障碍组患者血清Hcy水平高于轻度认知功能障碍组(P<0.05);组间其他基线资料比较,差异均无统计学意义(P>0.05);经点二列相关性检验,结果显示,血清Hcy水平与AD患者认知功能障碍严重程度呈正相关(r=0.589,P<0.001);经logistic回归分析结果显示,高血清Hcy水平是AD患者中重度认知功能障碍的风险因素(OR>1,P<0.05);绘制ROC曲线,结果显示,血清Hcy水平评估AD患者中重度认知功能障碍的AUC值为0.853时,有中等评估效能,最佳截断值为16.385μmol/L,敏感度为0.745,特异度为0.690,约登指数为0.435。结论:血清Hcy水平与AD患者认知功能障碍有一定关系,且高血清Hcy水平提示AD患者认知功能障碍越严重。

Objective:To analyze the relationship between serum homocysteine(Hcy)level and cognitive dysfunction in patients with Alzheimer’s disease(AD).Method:A prospective study was conducted on 78 patients with AD admitted to the Fifth People’s Hospital of Jiujiang from January to July 2021.The serum Hcy level was detected during hospitalization,and the severity of cognitive dysfunction in AD patients were assessed by the mini mental state examination scale(MMSE)and divided into groups.Different baseline data and serum Hcy levels were compared between mild cognitive impairment group and moderate to severe cognitive impairment group,and the correlation between serum Hcy level and cognitive dysfunction in AD patients was analyzed.Result:A total of 78 questionnaires were distributed this time,and 78 questionnaires were recovered.After excluding 2 invalid questionnaires with too short response time or inconsistent answers,76 valid questionnaires were available,with an effective recovery rate of 97.44%.A total of 76 patients were finally included.According to the MMSE score,29 patients had mild cognitive impairment,accounting for 38.16%.There were 47 cases of moderate to severe cognitive impairment,accounting for 61.84%.The serum Hcy level in patients with moderate and severe cognitive impairment was higher than that in patients with mild cognitive impairment(P<0.05).There were no statistical significant differences in others baseline data between groups(P>0.05).The results showed that the serum Hcy level was positively correlated with the severity of cognitive dysfunction in AD patients(r=0.589,P<0.001).The logistic regression analysis showed that high serum Hcy level was a risk factor for moderate and severe cognitive impairment in AD patients(OR>1,P<0.05).The ROC curve was drawn,the results showed that when the AUC value of serum Hcy level in the evaluation of moderate and severe cognitive impairment in AD patients was 0.853,there was a moderate evaluation efficiency.The best cut-off value was 16.385μmol/L,the sensitivity was 0.745,the specificity was 0.690,and the yoden index was 0.435.Conclusion:There is a certain relationship between serum Hcy level and cognitive dysfunction in AD patients,and high serum Hcy level suggests that the more serious cognitive dysfunction in AD patients.