同型半胱氨酸与阿尔茨海默病及血管性痴呆

目的研究同型半胱氨酸(Homocysteine,Hcy)及叶酸、维生素B_(12)与阿尔茨海默病(Alzheimer Dis- ease,AD)和血管性痴呆(Vascular dementia,VaD)的关系,并通过Hcy揭示AD发病的血管危险因素。方法用美国国立神经病学、语言障碍和卒中-阿尔茨海默病和相关疾病学会(NINCDS-ADRDA)标准的可能标准严格筛选AD患者35例,用ADDTC诊断标准筛选VaD患者30例,并同期选择31例无临床脑血管病史、无认知功能障碍的健康查体中心志愿者为对照组。取肝素抗凝的血浆用循环酶法进行Hcy的测定。取血清由全自动化学发光免疫检测仪进行叶酸和维生素B_(12)的测定。结果AD组和VaD组血浆Hcy水平显著高于对照组,血清叶酸和VitB_(12)水平显著低于对照组。VaD组存在痴呆程度越高血浆Hcy水平越高这一显著正相关关系,而AD组这一正相关关系无统计学意义;且发现VaD组患者MMSE评分越低其血浆Hcy水平越高这一显著负相关关系,而AD组这一关系仍无统计学意义。在所有研究对象中存在血浆Hcy水平与血清叶酸及VitB_(12)水平的显著负相关关系。结论提示高Hcy血症可能是引起AD和VaD的一个重要危险因素,Hcy作为一个新的血管因素加强了AD与血管危险因素之间的联系,并且提示积极治疗高Hcy血症在预防AD和VaD方面可能有积极意义。

Study on homocysteine in Alzheimer disease and vascular dementia

Objective To study homocysteine(Hey),folate,VitB_(12)in Alzheimer disease(AD)and vascular de- mentia(VaD),and to investigate the risk of AD associated with vascular factors through Hcy.Methods Thirty- five AD patients(AD group),conformed to the probable AD standard of NINCDS-ADRDA,and thirty VaD patients (VaD group),conformed to the ADDTC were analyzed.Thirty-one persons without dementia who took the health examination during the same period were recruited to control group.Patients of the two groups were scored with MMSE.The concentration of serum vitamin B_(12)and folate were examined with the radioimmunoassay.Plasma Hcy was measured with enzyme circulation.Results The level of plasm Hcy in AD group and VaD group was signifi- cantly higher than that of the control group.The serum folate and vitamin B_(12)in AD and VaD group were signifi- cantly lower than those of the control group.There was extremely significant difference between them(P<0.05). There was positive correlation between plasma Hcy and CDR in VaD group.So was MMSE in VaD group.But in AD group the positive correlation was without significant differences(P>0.05).There was negative correlation between Hcy and folate in all objects,so was between Hcy and vitamin B_(12)in all objects.Conclusion The level of plasma Hcy of AD and VaD patients is related to the disorder of intelligence.AD is also related to vascular factors.