血浆同型半胱氨酸水平与老年期痴呆及痴呆程度的相关性分析

目的]探讨血浆同型半胱氨酸(Hcy)水平与老年期痴呆及痴呆程度的相关性.方法]选取2015年12月至2018年12月在本院神经内科接受治疗的老年脑血管疾病患者209例,其中94例痴呆患者作为观察组,115例非痴呆患者作为对照组,依据Hachinski缺血指数量表将观察组94例患者分成血管性痴呆(VD)30例,混合性痴呆(MD)32例,阿尔茨海默病(AD)32例;痴呆患者程度依据MMSE量表区分,重度18例,中度36例,轻度40例;比较观察组与对照组患者的临床资料,对有差异因素行多因素回归分析;比较观察组不同痴呆类型和不同痴呆程度患者与对照组患者间血清Hcy含量差异.结果]观察组患者年龄、Hcy水平升高比例、既往卒中史患者比例显著高于对照组,差异有统计学意义(P<0.05);两组患者性别、糖尿病及高血压患者比例比较差异无统计学意义(P>0.05);血清Hcy含量高于15 mmol/L、既往脑卒中史及高龄是老年脑血管疾病患者发生痴呆的独立危险因素(P<0.05);对照组、MD组、AD组、VD组血清Hcy含量依次升高;对照组、轻度、中度、重度组血清Hcy含量也呈依次升高,组间比较差异均有统计学意义(P<0.05).结论]血浆Hcy水平是痴呆高危因素之一,且与痴呆严重程度密切相关.

Analysis of the Relationship between the Level of Homocysteine in Plasma and the Degree of Dementia

Objective]To explore the relationship between the level of plasma homocysteine(Hey)and the degree of senile dementia.Methods]From December 2015 to December 2018,209 elderly patients with cerebrovascular diseases who were treated in the Department of Neurology of our hospital were selected as the observation group.including 94 dementia patients,115 non dementia patients as the control group,94 patients in the observation group were divided into vascular dementia(VD)30 cases,mixed dementia(MD)32 cases,Alzheimer's disease(AD)32 cases according to the Hachinski ischemic index scale;the degree of dementia patients was divided according to the MMSE scale,18 cases were severe,36 cases were moderate,40 cases were mild;he clinical data of the comparison group and the control group showed that there were differences in the causes The differences of Hey in serum between the patients of different dementia types and degrees in the observation group and the control group were compared.Results]The age,the proportion of Hcy level increase and the proportion of patients with previous stroke history in the observation group were significantly higher than those in the control group(P<0.05);there was no significant difference between the two groups in terms of gender.the proportion of patients with diabetes mellitus and hypertension(P>0.05);the serum Hcy content was higher than 15 Mol/L,previous stroke history and old age were independent risk factors for dementia in elderly patients with cerebrovascular disease(P<0.05);the serum Hey content in the control group,MD group,ad group and VD group increased in turn;the serum Hcy content in the control group,mild,moderate and severe groups also increased in turn,with statistical significance(P<0.05).Conclusion]Plasma Hey level is one of the high risk factors of dementia,and is closely related to the severity of dermentia.