同型半胱氨酸与阿尔茨海默病的临床研究  

The clinical studies of hyperhomocysteinemia and Alzheimer’s disease

作　　者：李艳玲[1] 侯玥[2] 牛超[2] 虞立霞[2] 程义勇[2] 洪燕[2] 

机构地区：[1]天津市中医药大学第一附属医院营养科,天津300193 [2]军事医学科学院卫生学环境医学研究所,天津300050

出　　处：《中国应用生理学杂志》2013年第2期116-118,127,共4页Chinese Journal of Applied Physiology

基　　金：达能膳食营养研究与宣教基金项目(DIC2010-09)

摘　　要：目的:研究同型半胱氨酸(Hcy)及叶酸在阿尔茨海默病发病中的作用。方法:选择符合诊断标准患有阿尔茨海默病(AD)的患者36例,对照组32例。对受试者进行认知功能检测,同时测定血浆中Hcy及叶酸水平。比较AD患者和对照组的Hcy及叶酸水平,对AD组受试者血浆Hcy水平与认知功能障碍程度进行相关性分析。采取3 d 24 h回顾法对受试者或其家属进行膳食调查,观察和计算叶酸的摄入量是否与AD的发生有关。结果:AD患者血清Hcy水平显著高于对照组,AD组受试者血清Hcy水平与临床痴呆评定量表(CDR)分值呈显著正相关,与MMSE分值呈显著负相关。AD患者血清和膳食叶酸水平显著低于对照组。结论:高同型半胱氨酸血症是诱发AD发病的危险因素之一,Hcy水平与认知水平呈显著负相关,老年人叶酸缺乏是Hcy水平升高引发AD的重要原因。Objective： To observe the correlation between the decline of cognitive function and the level of plasma homocysteine in patients with Altheimer＇ s disease （AD）. Methotls： Thirty six AD patients were selected from hospitals in Tianjin. The enrolled patients were in accord with the diagnosis criteria. Thirty two control subjects were corresponding patients without AD in the period. Blood samples were extracted from each subject to determine the levels of homocysteine （Hey） and folate. Cognitive status was evaluated by the minimental state examination （MMSE） and clinical dementia rating scale （CDR）. Results： The mean value of serum Hcy concentration [ （ 17.51 ± 5.62） μnol/L]ofADgroupwashigherthanthatofcontrolgroup[（12.38±4.25）μnol/L]. The serum [（5.17± l.76） μg/L] and diet folate [（206.94±44.51） μg/d] concentrationofADgroupwerelowerthanthoseofcontrelgroup[（7.92±2.22）μo/L, （2.59.74±41.92）twJ d ]. The incidence of hyperhomocysteinemia in AD group （64%） was higher than that in control group （ 22 % ）. A significant relation between Hcy concentrations and the CDR was observed. With the increase of Hcy concentrations the CDR rised, and with the increase of Hcy concentrations the MMSE decreased. Conclusion： Hyperhomocysteinemia is one of the risk factors inducing the onset of AD. There is a significant negative correlation between Hcy levels and cognitive levels in AD group. Folate deficiency is an important reason to cause elevated Hcy levels in AD.

关 键 词：阿尔茨海默病 同型半胱氨酸 叶酸 

分 类 号：R151.2[医药卫生—营养与食品卫生学]