阿尔茨海默病精神行为症状与HCY水平及颈动脉粥样硬化的关系探究

目的 探讨阿尔茨海默病的精神行为症状（Behavioral and psychological symptoms，BPSD）与血浆同型半胱氨酸（Homocysteine，HCY）水平及颈动脉粥样硬化的关系。方法 选取2015 年10 月～2017 年10 月我院收治的阿尔茨海默病患者87 例，根据阿尔茨海默病患者的神经精神问卷测评结果将其分为两组，BPSD 组（n=54）与非BPSD组（n=33）。对患者的血浆HCY 进行测定，并采用彩色多普勒检测颈总动脉（Common carotid artery，CCA）与颈内动脉（Internal carotid artery，ICA）内径及内-中膜层厚度（Intima media thickness，IMT），比较两组患者间的差异，并分析血浆HCY 水平及颈动脉粥样硬化与BPSD 症状的相关性。结果 BPSD 组患者的血浆HCY 水平明显高于非BPSD 组患者，且高HCY 血症的百分比也明显高于非BPSD 组患者，差异均有统计学意义（P＜0.05）；颈动脉超声结果显示，BPSD 组患者的CCA、ICA 内径和IMT 值均明显高于非BPSD 组患者，两组间差异显著（P＜0.05）。经多因素Logistic 回归分析，血浆HCY 水平、CCA 颈动脉内径和IMT、ICA 颈动脉内径和IMT 均是BPSD 症状的独立危险因素（OR=3.328、2.824、2.627、2.544 和2.417，P＜0.05）。结论 血浆HCY 水平及动脉粥样硬化程度可能与阿尔茨海默病患者的BPSD 症状存在一定的相关性。

Relationships between behavioral and psychological symptoms of Alzheimer's disease and HCY level and carotid atherosclerosis

Objective To investigate the relationships between behavioral and psychological symptoms (BPSD) in Alzheimer''s disease and plasma homocysteine (HCY) and carotid atherosclerosis.Methods A total of 87 patients with Alzheimer''s disease treated in our hospital from October 2015 to October 2017 were selected and divided into two groups based on the result of psychological survey,the BPSD group (n=54) and the non-BPSD group (n=33).The plasma HCY level was detected and color Doppler was used to detect the internal diameter and intima media thickness(IMT) of the common carotid artery (CCA) and internal carotid artery (ICA).The differences were compared between the two groups.And the relationships between plasma HCY and carotid atherosclerosis and BPSD were analyzed.Results The HCY level was significantly higher in the BPSD group than that in the non-BPSD group,and the percentage of hyperhomocysteinemia was also significantly higher in the BPSD group than that in the non-BPSD group (P<0.05).The internal diameters of CCA and ICA and value of IMT were significantly higher in the BPSD group than those in the non-BPSD group(P<0.05).Multivariate Logistic regression analysis showed that plasma HCY levels,CCA carotid diameter and IMT,ICA carotid diameter and IMT were independent risk factors for BPSD symptoms (OR=3.328,2.824,2.627,2.544,and 2.417,respectively,P<0.05).Conclusion Plasma HCY levels and atherosclerosis may be associated with BPSD symptoms in patients with Alzheimer''s disease.