摘要
目的研究维生素B_(12)和叶酸水平以及同型半胱氨酸是否对阿尔茨海默症(AD)患者存在潜在影响。方法运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)标准严格筛选AD患者95例。从体检中心选取年龄、性别及受教育程度匹配的无脑血管病、无认知障碍的健康对照组76例。采用化学发光微粒子免疫分析法检测171例年龄≥50岁的老年痴呆患者血清维生素B_(12)和叶酸水平。采用肝素抗凝的血浆进行循环酶法Hcy测定。探讨血清低水平维生素B_(12)和叶酸以及高水平同型半胱氨酸是否是老年痴呆发生的危险因素。认知功能的评价采用目前通用的神经心理测试:中文版简易精神状态检查表(MMSE)。采用Logistic回归分析评估血清维生素B_(12)、叶酸以及同型半胱氨酸与老年痴呆患病风险的关系。结果 171例中153例叶酸正常,其中对照组79例(51.63%),实验组74例(43.27%);124例维生素B_(12)正常,其中对照组60例(48.39%),实验组64例(51.61%);101例同型半胱氨酸正常,其中对照组51例(50.50%),实验组50例(49.50%)。作各协变量调整后,AD患者血清维生素B_(12)及叶酸水平以及同型半胱氨酸与CMMES评分无相关性(P>0.05)。但低血清维生素B_(12)水平以及低叶酸水平与AD患病风险相关。结论血清维生素B_(12)和叶酸水平以及同型半胱氨酸水平与AD患者认知功能之间无明显关联。低水平维生素B_(12)以及低水平叶酸可能通过某种机制增加AD患病风险,低水平同型半胱氨酸可能通过某种机制降低AD患病风险。
Objective To investigate the correlations of vitamin B_(12) and folic acid and homocysteine with Alzheimer's disease(AD).Methods Serum vitamin B_(12) and folic acid levels were determined by chemiluminescence microparticle immunoassay in 95 elderly dementia patients≥50 years old and 76 cognitive normal subjects(normal control group).The low levels of vitamin B_(12) and folic acid and homocysteine as high-risk factors for AD were analyzed.Cognitive function was evaluated with comprehensive neuropsychological tests,such as Chinese Version of Mini Mental State Examination(CMMSE).Pearson's correlation analysis was performed to evaluate the relationship among serum vitamin B_(12),folic acid,homocysteine,age,education year,and cognitive function in all groups.Logistic regression was used to evaluate the association of vitamin B_(12),folic acid and homocysteine with AD.Results A total 96 patients with AD were determined.There were 153 cases of folic acid in the 171 cases,including 79 in normal group(51.63%)and 74 cases in the experimental group(43.27%).The normal number of vitamin B_(12) was found in 124 cases,including 60 in normal group(48.39%),and 64 cases in the experimental group(51.61%).101 homocysteine was normal.Among them,51 cases(50.50%)and 50 cases(49.50%)were normal.Vitamin B_(12),folic acid or homocysteine level had no correlation with CMMSE scores after covariates' adjustments(P>0.05).Low vitamin B_(12) level and folic acid was correlated with the risk of AD.Conclusion Vitamin B_(12),folic acid and homocysteine are not correlated with cognitive impairment.However,low vitamin B_(12) level and folic acid may be correlated with an increased risk for AD;Low levels of homocysteine may reduce AD risk by some mechanism.
出处
《中国实用神经疾病杂志》
2017年第19期43-47,共5页
Chinese Journal of Practical Nervous Diseases
