非痴呆性血管认知障碍患者认知功能与同型半胱氨酸及对氧磷酶1的相关性研究

摘要

Objective To study the relationship of cognitive function and serum Hcy level and Pon-1 activity in patients with non-dementia vascular cognitive impairment (VCI).Methods Two hundred and one acute ischemic stroke (AIS) patients were divided into non-dementia VCI group (n=96) and control group (n=105) according to the MoCA Scale.Their serum Hcy level and Pon-1 activity were meausred.The relationship of cognitive impairment with serum Hcy level and Pon-1 activity was analyzed.Results The serum Hcy level was significantly higher while the Pon-1 activity was significantly lower in non-dementia VCI group than in control group (P＜0.05,P＜0.01).The total MoCA score,visual spatial/executive ability score,computational power score,language fluency score,abstraction ability score,delayed memory score and directional force score were significantly lower in non-dementia VCI group than in control group (P＜0.01).The serum Hcy level was negatively related with the total MoCA score,visual spatial/executive ability score,naming and attention ability score (r=-0.560,P＜0.01;r=-0.564,P＜0.01;r=-0.399,P＜0.01,r=-0.420,P＜0.05) while the PON-1 activity was positively related with the total MoCA score and visual spatial/executive ability score (r=0.432,r=0.463,P＜0.01).Conclusion Elevated serum Hcy level and decreased Pon-1 activity can show the different severities of connitive impairment and can thus be used as an objective indicator for the early diagnosis of non-dementia VCI.%目的 研究同型半胱氨酸(Hcy)水平及血清对氧磷酶1活性变化与非痴呆性血管认知障碍(VCIND)患者认知功能的关系.方法 选择符合VCIND诊断标准的急性脑卒中患者201例,根据蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)分为VCIND组96例和对照组105例,比较2组患者Hcy、对氧磷酶1活性,分析VCIND患者认知障碍与Hcy、对氧磷酶1活性的相关性.结果 VCIND组Hcy水平明显高于对照组,对氧磷酶1活性明显低于对照组(P＜0.05,P＜0.01).VCIND组MoCA总分、视空间/执行能力、计算力、语言流畅性、抽象能力、延迟记忆力、定向力评分较对照组明显降低,差异有统计学意义(P＜0.01).VCIND患者Hcy与MoCA总分及子项目中的视空间/执行能力、命名和注意力评分呈负相关(r=-0.560,P＜0.01;r=0.564,P＜0.01;r=-0.399,P＜0.01;r=-0.420,P＜0.05).对氧磷酶1与MoCA总分及子项目中的视空间/执行能力评分呈正相关(r=0.432,r=0.463,P＜0.01).结论 Hcy水平增高以及对氧磷酶1活性下降的程度能较好地反映不同程度的认知损害,可作为筛查VCIND患者的客观指标,协助对VCIND患者做出早期诊断.