老年性痴呆患者血浆NO和H_2S的变化及意义  

The Gasotransmitter NO and H_2S in Alzheimer′s disease

作　　者：刘祥琴[1] 刘小琦[1] 晏宁[2] 

机构地区：[1]四川省医学科学院四川省人民医院检验科,成都610072 [2]重庆医科大学附属第二医院神经内科,400016

出　　处：《重庆医学》2012年第1期19-21,24,共4页Chongqing medicine

摘　　要：目的探讨老年性痴呆(AD)患者血浆中一氧化氮(NO)、硫化氢(H2S)、同型半胱氨酸(Hcy)和C反应蛋白(CRP)的水平变化及临床意义。方法收集AD患者(AD组)31例,正常对照组(NC组)23例。全部研究对象均进行简明精神状态量表(MMSE)、日常生活能力量表(ADL)、Hachinski缺血指数(HIS)和Hamilton抑郁量表(HRSD)量表检测,AD患者用全面衰退量表(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NO、H2S、Hcy及CRP的含量;进行比较和相关性分析。结果 (1)NO水平:AD组血浆NO水平为(36.06±13.92)μmol/L较对照组[(60.17±19.77)μmol/L]明显降低(P<0.01)。Spearman相关分析显示,血浆NO水平与AD的严重程度呈负相关,与AD患者的MMSE评分呈正相关。(2)H2S水平:AD组血浆H2S水平为(34.03±6.78)μmol/L较对照组[(44.92±6.53)μmol/L]明显降低(P<0.01)。Spearman相关分析显示血浆H2S水平与AD的严重程度呈负相关。(3)Hcy水平:AD组血浆Hcy水平为(14.02±2.95)μmol/L显著高于对照组的[(9.79±2.51)μmol/L](P<0.01)。Spearman相关分析显示血浆Hcy水平与AD的严重程度呈正相关。(4)CRP水平:AD组血浆CRP水平为(1.25±1.35)mg/L与对照组[(1.11±1.30)mg/L]比较,差异无统计学意义(P>0.05)。(5)AD组内4个指标血浆水平的Pearson相关分析显示,AD组中血浆Hcy水平与H2S水平呈负相关,而其余各指标没有明显的相关性,即从血浆水平不能看出四者间存在相关性。结论 AD患者血浆NO和H2S水平显著下降,Hcy水平显著升高,与AD患者的病情严重程度密切相关。Objective To clarify the role of NO,endogenous H2S,Hcy and CRP in the pathogenesis of Alzheimer′s disease（AD）.The plasma concentrations of NO,H2S,Hcy and CRP were measured in 31 patients with AD and 23 normal controls（NC）.Methods 31 patients with Alzheimer′s disease（AD） and 23 normal controls（NC） were recruited.Mini Mental State Examination（MMSE）,Activity of Daily Living Scale（ADL）,Hachinski Ischemic Score（HIS） and Hamilton′s depression scale（HRSD） were performed in all patients and controls.The severity of AD was evaluated according to Global Deterioration Scale（GDS）.The plasma levels of NO,H2S,Hcy and CRP were measured in all the objects.Results ①the plasma level of NO was significantly lower in the patients with AD（36.06±13.92）μmol/L than in NC（60.17±19.77）μmol/L（P〈0.01）.②the plasma level of H2S was significantly lower in the patients with AD（34.03±6.78）μmol/L than in NC（44.92±6.53）μmol/L（P〈0.01）.③the plasma level of Hcy was significantly higher in the patients with AD（14.02±2.95）μmol/L than in NC（9.79±2.51）μmol/L（P〈0.01）.Through rank correlation analysis,the severity of AD was positive correlation with the plasma concentration of Hcy.④The plasma level of CRP had not significant difference in the patients with AD and NC.Conclusion Gasotransmitter NO,H2S and Hcy are involved in the pathogenesis of AD,and their alteration in level may be associated with the severity of AD.

关 键 词：阿尔茨海默病 一氧化氮 硫化氢 同型半胱氨酸 C反应蛋白 

分 类 号：R749.16[医药卫生—神经病学与精神病学]