腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性

doi:10.6040/j.issn.1671-7554.0.2015.922

摘要/Abstract

摘要： 目的探讨腔隙性脑梗死患者血管性认知障碍(VCI)程度与血浆同型半胱氨酸(Hcy)水平、梗死灶数目及总体积的相关性。方法选择2011年10月至2013年10月,在滕州市中医医院神经内科首次住院的腔隙性脑梗死患者196例,采用简易精神状态检查表(MMSE)评分,将患者分为认知功能正常组(155例)、轻度认知障碍组(35例)和痴呆组(6例),以201名健康体检者为对照组。所有入选患者均进行血Hcy检测及头颅MRI检查,计算腔隙梗死灶数目及每个腔隙梗死灶体积(mm³)及总体积;对腔隙性脑梗死患者认知功能与血Hcy水平、腔隙梗死病灶数目及总体积之间的相关性进行多元线性回归分析。结果腔隙性脑梗死患者中Hcy≥10 μmol/L者比率高于对照组(91.84% vs 65.67%, P<0.01);痴呆组血Hcy水平［(51.37±8.12)μmol/L］与轻度认知障碍组［(28.06±7.56)μmol/L］、认知正常组［(21.70±6.92)μmol/L］、对照组［(11.58±3.73)μmol/L ］比较,差异均有统计学意义(P<0.01);痴呆组、轻度认知障碍组和认知功能正常组梗死灶数目［(8.00±1.67)、(4.77±0.77)、(3.52±0.81)个］及总体积［(27.42±9.34)、(14.96±6.89)、(8.81±3.71)mm³］分别进行组间比较,差异均有统计学意义(P<0.01)。结论腔隙性脑梗死患者认知功能MMSE评分与血Hcy水平呈负相关,与梗死灶数目及梗死灶总体积亦呈负相关。

关键词: 磁共振成像, 同型半胱氨酸, 腔隙性脑梗死, 认知功能障碍

Abstract: Objective To investigate the correlation between the extent of the vascular cognitive impairment(VCI)and the level of homocystein(HCY)in plasma as well as the number and volume of infarct in patients with lacunar cerebral infarction. Methods A total of 196 lacunar infarction patients who were hospitalized in Tengzhou Traditional Chinese Hospital, from Oct. 2011 to Oct. 2013, for the first time and 201 healthy volunteers(control group)were included in this study. Levels of plasma Hcy were detected in all subjects. The number and total volume of lacunar infarct(mm³)were determined by using MRI detection. Patients were divided into normal cognitive group(n=155), mild VCI group 山东大学学报 (医学版)54卷10期 -董芳,等.腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性 \=-(n=35)and dementia group(n=6), according to the cognitive function score of Minimum Mental State Examination(MMSE). The levels of plasma Hcy were compared between patients and control group. Spearman correlation was used to analyze the correlations among the cognitive function and the levels of plasma Hcy, the number and total volume of lacunar infarction. Results The proportion of subjects with plasma Hcy levels ≥10 μmol/L in patients with lacunar infarction(91.84%)was higher than that in the controls(65.67%). The levels of plasma Hcy in dementia group ［(51.37±8.12 )μmol/L］, mild VCI group ［(28.06±7.56)μmol/L］ and normal cognitive group ［(21.70±6.92)μmol/L］ were significantly higher than that in control group(P<0.01). The differences in total number and volume of lacunar infarcts between dementia group ［number 8.00±1.67; total volume(27.42±9.34)mm³］ and mild VCI group ［number 4.77±0.77; total volume(14.96±6.89)mm³］ as well as normal cognitive group ［number 3.52±0.81; total volume(8.81±3.71)mm³］ were statistically significant(P<0.01). Conclusion There is negative correlation between the cognitive level detected by MMSE and HCY, and also between the number and the total volume of infarction in patients with cerebral lacunar infarction.

Key words: Vascular cognitive impairment(VCI), Lacunar infarction, Homocysteine, Magnetic resonance imaging(MRI)

中图分类号:

R743.3

董芳,杜怡峰. 腔隙性脑梗死患者认知障碍与高同型半胱氨酸血症、梗死灶数目及体积的相关性[J]. 山东大学学报（医学版）, 2016, 54(10): 46-49.

DONG Fang, DU Yifeng. Correlation among cognitive impairment and high homocysteinemia as well as the number and volume of infarct in patients with lacunar cerebral infarction[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 46-49.

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