血清同型半胱氨酸及颈动脉斑块易损性评分与老年脑小血管病患者脑白质病变和认知功能障碍的关系  

Relationship between serum homocysteine,score of carotid plaque vulnerability and white matter lesion,cognitive dysfunction in elderly patients with cerebral small vascular disease

作　　者：鲍景蕾 常万生[1] 赵延军 BAO Jing-lei;CHANG Wan-sheng;ZHAO Yan-jun(Department of Neurology,the Second People's Hospital of Liaocheng,Liaocheng 252600,Shandong,China)

机构地区：[1]聊城市第二人民医院神经内科,山东聊城252600

出　　处：《川北医学院学报》2025年第4期450-453,共4页Journal of North Sichuan Medical College

基　　金：山东省医药卫生科技发展计划项目(202114010801)。

摘　　要：目的:分析老年脑小血管病(CSVD)患者血清同型半胱氨酸(Hcy)及颈动脉斑块易损性评分与其脑白质病变和认知功能障碍的相关性。方法:选取126例老年CSVD患者作为研究对象,按照认知功能水平不同将患者分成认知障碍组(n=66)和非认知障碍组(n=60),比较两组患者的一般临床资料、血清Hcy浓度、颈动脉斑块易损性评分、脑白质病变分级(Fazekas评分)及认知功能[简易精神状态量表(MMSE)评分];参照所有患者的Fazekas评分将患者分为脑白质病变组与脑白质正常组,比较两组患者的血清Hcy水平和颈动脉斑块易损性评分,并分析患者血清Hcy浓度、颈动脉斑块易损性评分与Fazekas评分和MMSE评分的相关性。结果:与非认知障碍组比较,认知障碍组的年龄更大,高血压和痴呆家族史比例、血清D-二聚体水平、Hcy水平、颈动脉斑块易损性评分及Fazekas评分均显著更高(P<0.05),而MMSE评分显著更低(P<0.05),与脑白质正常组比较,脑白质病变组的Hcy水平和斑块易损性评分均较高(P<0.05)。血清Hcy水平、颈动脉斑块易损性评分均与Fazekas评分正相关,与MMSE评分负相关(P<0.05)。结论:老年CSVD患者血清Hcy和颈动脉斑块易损性评分与其脑白质病变和认知功能障碍程度之间均呈正相关关系。Objective:To explore the correlation between serum homocysteine(Hcy),score of carotid plaque vulnerability and white matter lesion,cognitive dysfunction in elderly patients with cerebral small vascular disease(CSVD).Methods:A total of 126 elderly patients with CSVD were enrolled as the research objects.According to cognitive function level,they were divided into impairment group(n=66)and non-impairment group(n=60).The general clinical data,level of serum Hcy,scores of carotid plaque vulnerability,white matter lesion grading(Fazekas)and cognitive function[Mini-Mental State Examination(MMSE)]in the two groups were compared.According to the Fazekas score of all patients,they were divided into a group with white matter lesions and a group with normal white matter.The serum Hcy levels and carotid plaque vulnerability scores of the two groups were compared,the correlation between level of serum Hcy,score of carotid plaque vulnerability and Fazekas score and MMSE score was analyzed.Results:Compared with non-impairment group,age,proportions of hypertension and dementia family history,levels of serum D-dimer and Hcy,scores of carotid plaque vulnerability and Fazekas were higher in impairment group(P<0.05),MMSE score was lower(P<0.05).Compared with the normal white matter group,the level of serum Hcy and score of carotid plaque vulnerability were higher in the white matter lesion group(P<0.05).The level of serum Hcy and score of carotid plaque vulnerability were positively correlated with Fazekas score,while negatively correlated with MMSE score(P<0.05).Conclusion:The level of serum Hcy and score of carotid plaque vulnerability are positively correlated with white matter lesion and cognitive dysfunction in elderly patients with CSVD.

关 键 词：脑小血管病 脑白质病变 认知功能障碍 同型半胱氨酸 颈动脉斑块易损性评分 

分 类 号：R543.5[医药卫生—心血管疾病]