阿尔茨海默病和血管性痴呆患者血浆硫化氢与同型半胱氨酸水平的变化及意义  

Plasma levels of endogenous hydrogen sulfide and homocysteine in patients with Alzheimer＇s disease and vascular dementia and the significance thereof

作　　者：刘祥琴[1] 刘小琦[2] 蒋萍[1] 黄华[1] 晏勇[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,400016 [2]四川省人民医院检验科

出　　处：《中华医学杂志》2008年第32期2246-2249,共4页National Medical Journal of China

摘　　要：目的探讨阿尔茨海默病（AD）、血管性痴呆（VD）患者血浆中硫化氢（H2S）和同型半胱氨酸（Hey）水平的变化及临床意义。方法收集AD患者31例、VD患者28例、脑血管疾病（CVD）患者20例、正常对照组23名。全部对象均进行简明精神状态量表（MMSE）、日常生活能力量表（ADL）、Haehimki缺血指数（HIS）和Hamihon抑郁量表（HRSD）等检测，用全面衰退量表（GDS）分级。取空腹静脉血6ml，迅速分离血浆并置于-70℃冰箱保存。分别测定血浆H2S及Hey的含量，进行比较和相关性分析。结果（1）AD组、VD组和CVD组血浆H2S水平均明显低于正常对照组[（34±7）μmol／L、（36±5）μmol／L、（37±7）μmol／LV8（454-7）μmol／L，均P〈0．01]；AD、VD和CVD3组之间血浆H2S水平差异无统计学意义（P〉0．05）。进一步的相关性分析显示：血浆H2S水平与AD患者的病情严重程度呈负相关。（2）AD组血浆Hey为（14．0±3．0）μmol／L、VD组为（16．0±6．1）μmol／L、CVD组为（14．4±4．9）μmol／L，均明显高于正常对照组[（9．8±2．5）μmol／L，均P〈0．01]。进一步的相关性分析显示：血浆Hey水平与AD及VD患者的病情严重程度均呈正相关（r=0．683、P〈0．01，r=0．292、P〈0．05）。结论AD和VD患者血浆H2S降低、Hey升高，并与患者的病情严重程度密切相关。Objective To investigate the plasma levels of endogenous hydrogen sulfide （ H2S） , a gasotransmitter, and homocysteine （Hcy） in patients with Alzheimer＇ s disease （ AD）, vascular dementia （ VD）, and cerebrovascular disease （CVD） and their role in the pathogenesis of AD and VD. Methods 31 AD patients, 28 VD patients, 20 CVD patients , and 23 normal controls （NC group） underwent examination of plasma concentrations of H2S and Hcy, mini mental state examination （MMSE）, activity of daily living scale （ADL）, Hachinski ischemic score （HIS） , and Hamilton＇s depression scale （HRSD）. The severity of AD and VD was evaluated according to the global deterioration scale （GDS）. Results （ 1 ） The plasma H2Slevels of the AD, VD, and CVD patients were （34 ±7）, （36 ±5）, and （37 ± 7） μmol/L respectively, all significantly lower than that of the NC group [ （45 ±7） μmol/L,all P 〈0. 01 ]. However, there were no significant differences in the plasma H2S level among the AD, VD, and CVD patients （ all P 〉 0. 05）. The plasma H2 S concentration was negatively correlated the severity of AD. （2） The plasma Hcy levels of the AD, VD, and CVD patients were （ 14. 0 ± 3.0）, （ 16. 0 ± 6. 1 ）, and （ 14. 4 ± 4. 9）μmol/L respectively, all significantly higher than that of the NC group [ （ 9. 8± 2. 5 ） μmol/L, P 〈 0. 01 ）. However, there was no significant difference in the plasma Hcy level among these 3 groups （ all P 〉 0. 05 ）. The plasma Hcy concentration was positively correlated with the severity of AD or VD. Conclusion H2S and Hcy are both involved in the pathogenesis of AD, VD, and CVD, and its alteration in level may be associated with the severity of AD and VD.

关 键 词：硫化氢 阿尔茨海默病 痴呆 血管性 同型半胱氨酸 

分 类 号：R686[医药卫生—骨科学]