摘要
目的探讨阿尔茨海默病(AD)患者的认知功能及痴呆的精神行为症状(BPSD)与血尿酸(UA)、同型半胱氨酸(Hcy)水平之间的关系.方法收集126例AD患者为AD组,采用简明精神状态量表(MMSE)、临床痴呆量表(CDR)对AD患者进行测评,分为认知正常组和认知减退组,认知减退组再分为轻度、中度、重度组;采用神经精神问卷(NPI)进行测评,分为伴有BPSD组与不伴BPSD组,同期健康体检者90例为对照组,测定并比较各组血Hcy、UA水平,采用多因素Logistic回归分析评估AD患者认知功能减退的危险因素.结果多因素Logistic回归分析显示,AD患者认知功能减退与高龄、高Hcy水平、低UA水平有关(P<0.05),而与SBP、DBP、性别、受教育程度、TG、TC、FBG、HbA1(%)无关(P>0.05).AD组血UA水平显著低于对照组(P<0.05),而血浆Hcy水平显著高于对照组(P<0.05);轻度、中度、重度AD组间比较,痴呆程度越重,血浆Hcy水平越高,血清UA水平越低;AD伴BPSD组血浆Hcy水平高于不伴BPSD组(P<0.05).结论高龄、高Hcy、低UA水平是AD患者认知功能减退的危险因素,血浆Hcy升高水平、UA降低水平与AD患者的痴呆严重程度具有相关性,高Hcy水平与AD患者的精神行为症状有关.
Objective To investigate the relationship between plasma homocysteine(Hcy), uric acid(UA) levels and cognitive functions, behavioural and psy-chological symptoms of dementia(BPSD) in Alzheimer’s disease. Methods The plasma Hcy, UA levels were measured and compared in 86 patients with AD and 90 normal healthy persons. Patients in AD group were divided into cognitive normal group and mild, moderate, severe dementia group by using mini-mental state examination(MMSE) and the Clinical Dementia Scale(CDR) to evaluate the cognitive function. Patients in AD group were divided into BPSD group and non-BPSD group by using the neuropsychology questionnaire(NPI) to evaluate The symptoms of mental behavior. Multivariate logistic regression analysis was used to assess the risk factors for cognitive decline in AD patients. Results Multivariate logistic regression analysis showed that cognitive decline in AD patients was associated with advanced age, high Hcy level, and low UA level(P<0.05), but not related to SBP, DBP, gender, education level, TG, TC, FBG, HbA1(%). 0.05). The blood UA level in the AD group was significantly lower than that in the control group(P<0.05), while the plasma Hcy level was significantly higher than the control group(P<0.05). Compare with mild, moderate, and severe AD groups, the more dementia in AD patients, the higher plasma Hcy levels and the lower serum UA levels were detected. Plasma Hcy levels in BPSD group were higher than non-BPSD group(P<0.05). Conclusions Age, high Hcy, and low UA levels are risk factors for cognitive decline in AD patients. Plasma levels of Hcy and UA are associated with the severity of dementia in AD patients. High Hcy levels are associated with mental behavioral symptoms in AD patients.
作者
张珊珊
季一飞
龙继发
张翼
杨旭
ZHANG Shanshan;JI Yifei;LONG Jifa;ZHANG Yi;YANG Xu(Department of Neurology, Nanchang Central Hospital,Nanchong 637000,Sichuan,China)
出处
《西部医学》
2019年第6期863-866,872,共5页
Medical Journal of West China
基金
国家自然科学基金(81870966)
南充市科技局基金(NSMC20170454)
关键词
阿尔茨海默病
同型半胱氨酸
尿酸
Alzheimer's disease
Plasma homocysteine
Uric acid
作者简介
通信作者:季一飞,博士后,本刊编委,E-mail:390684068@qq.com.
