非痴呆性血管认知障碍患者认知功能与同型半胱氨酸及对氧磷酶1的相关性研究  

Relationship of cognitive function with serum Hcy level and Pon-1 activity in patients with non-dementia vascular cognitive impairment

作　　者：苏榴芳[1] 张丽香[1] 肖继东[1] 唐士婷[1] 陈渊[1] 范秉林[1] 易祖芳[1] 陈志[1] 蔺心敬[1] 

机构地区：[1]广西壮族自治区人民医院神经内科,南宁530021

出　　处：《中华老年心脑血管病杂志》2017年第11期1133-1136,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广西医疗卫生适宜技术研究与开发课题(S201422-07);广西壮族自治区卫生厅自筹经费科研课题(Z2013371)

摘　　要：目的研究同型半胱氨酸(Hcy)水平及血清对氧磷酶1活性变化与非痴呆性血管认知障碍(VCIND)患者认知功能的关系。方法选择符合VCIND诊断标准的急性脑卒中患者201例,根据蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)分为VCIND组96例和对照组105例,比较2组患者Hcy、对氧磷酶1活性,分析VCIND患者认知障碍与Hcy、对氧磷酶1活性的相关性。结果 VCIND组Hcy水平明显高于对照组,对氧磷酶1活性明显低于对照组(P<0.05,P<0.01)。VCIND组MoCA总分、视空间/执行能力、计算力、语言流畅性、抽象能力、延迟记忆力、定向力评分较对照组明显降低,差异有统计学意义(P<0.01)。VCIND患者Hcy与MoCA总分及子项目中的视空间/执行能力、命名和注意力评分呈负相关(r=-0.560,P<0.01;r=-0.564,P<0.01;r=-0.399,P<0.01;r=-0.420,P<0.05)。对氧磷酶1与MoCA总分及子项目中的视空间/执行能力评分呈正相关(r=0.432,r=0.463,P<0.01)。结论 Hcy水平增高以及对氧磷酶1活性下降的程度能较好地反映不同程度的认知损害,可作为筛查VCIND患者的客观指标,协助对VCIND患者做出早期诊断。Objective To study the relationship of cognitive function and serum Hcy level and Pon-1 activity in patients with non-dementia vascular cognitive impairment（VCI）.Methods Two hundred and one acute ischemic stroke（AIS）patients were divided into non-dementia VCI group（n=96）and control group（n=105）according to the MoCA Scale.Their serum Hcy level and Pon-1 activity were meausred.The relationship of cognitive impairment with serum Hcy level and Pon-1 activity was analyzed.Results The serum Hcy level was significantly higher while the Pon-1 activity was significantly lower in non-dementia VCI group than in control group（P〈0.05,P〈0.01）.The total MoCA score,visual spatial/executive ability score,computational power score,language fluency score,abstraction ability score,delayed memory score and directional force score were significantly lower in non-dementia VCI group than in control group（P〈0.01）.The serum Hcy level was negatively related with the total MoCA score,visual spatial/executive ability score,naming and attention ability score（r=-0.560,P〈0.01;r=-0.564,P〈0.01;r=-0.399,P〈0.01,r=-0.420,P〈0.05）while the PON-1 activity was positively related with the total MoCA score and visual spatial/executive ability score（r=0.432,r=0.463,P〈0.01）.Conclusion Elevated serum Hcy level and decreased Pon-1 activity can show the different severities of connitive impairment and can thus be used as an objective indicator for the early diagnosis of non-dementia VCI.

关 键 词：高半胱氨酸 痴呆 血管性 认知障碍 危险因素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]