老年人认知功能与血清同型半胱氨酸水平  

Senile cognitive function and serum level of homocysteine

作　　者：王善信[1] 王仁峰[2] 赵贵芳[2] 

机构地区：[1]山东大学医学院精神病与心理卫生教研室,山东省济南市250012 [2]山东省精神卫生中心精神科,山东省济南市250014

出　　处：《中国临床康复》2005年第20期156-157,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:认知功能损害是老年痴呆的重要病理特征,近年来许多研究表明同型半胱氨酸水平升高是引起老年认知功能损害的一个重要因素。为此,对同型半胱氨酸与老年人认知功能关系的研究结果进行回顾,以阐明同型半胱氨酸引起老年人认知功能损害的机制,进而及早采取有效干预措施。资料来源:应用计算机检索Medline数据库1990-01/2004-12期间的关于同型半胱氨酸对老年人认知功能影响的文章,检索词“homocysteine,seniledementia,cognitivefunction″,限定文章语言种类为“English”。资料选择:对资料进行初审,选取流行病学研究、随机对照临床试验和实验研究。资料提炼:共收集到35篇关于同型半胱氨酸与老年人认知功能损害关系的流行病学研究、随机对照临床试验和实验研究,15项研究符合纳入标准,排除的20项研究中,11项研究因系重复的同一研究,9项为Meta分析或综述。资料综合:老年痴呆患者血浆同型半胱氨酸水平升高,认知功能损害与同型半胱氨酸水平显著相关,B族维生素、相关基因、年龄和性别等因素引起同型半胱氨酸水平升高,同型半胱氨酸在大脑通过神经毒性作用和血管作用引起认知功能损害。结论:同型半胱氨酸水平升高可能是老年性痴呆的一个重要危险因素,是其认知损害的独立危险因素;B族维生素缺乏是同型半胱氨酸水平升高的主要影响因素。在认知功能损害和大脑病理变化出现前用B族维生素治疗可能是有效的预防性干预措施。OBJECTIVE：Cognitive dysfunction is a vital pathological feature of senile dementia. In recent years, many researches indicate that the increased level of homocysteine is an important factor that causes the senile cognitive impairments.DATA SOURCES： An onlir, e search of Medline database was undertaken to identify the English articles about the iuflueuce of homocysteine on the cognitive function of elderly people published between January 1990 and December 2004 by using the keywords of “homocysteine, senile dementia,cognitive function”.STUDY SELECTION： After first check, the epidemiologcial studies, randomized controlled trials and experimental studies were selected.DATA EXTTACTION：Totally 35 epidemiologcial studies, randomized controlled trials and experimental studies about the association between homocysteine and senile cognitive impairments were collected, 15 studies met the inclusion criteria; Among the 20 excluded articles, 11 were repetitive and 9 were reviews or Meta analysis.DATA SYNTHESIS：Patients with senile dementia had elevated plasma homocysteine levels; Cognitive impairments were significantly correlated with homocysteine levels; The increased homocysteine levels were cause by B vitamins, related genetic factor, and other factors such as age and sex;Homocysteine led to the cognitive impairments due to its neurotoxic and vascular effects in the brain.CONCLUSION：Elevated homocysteine level is likely to be one of the important risk factors for senile dementia, and is an independent risk factor for the cognitive impairments： Vitamin B deficiency is the major factor that influences the elevated homocysteine level. Treatment of B vitamins at an early stage before the occurrence of cognitive impairement and pathological changes may be an effective preventive intervention.

关 键 词：痴呆 半胱氨酸 认知 血清同型半胱氨酸 认知功能损害 老年人 水平 HOMOCYSTEINE B族维生素缺乏 随机对照临床试验 

分 类 号：R714.246[医药卫生—妇产科学] R749.16[医药卫生—临床医学]