中国卒中杂志Issue(2)：100-105,6.DOI:10.3969/j.issn.1673-5765.2019.02.003
脑小血管病患者外周血同型半胱氨酸水平与认知功能的相关性研究
Study on the Correlation between Blood Homocysteine Level and Cognitive Function in Patients with Cerebrovascular Disease
摘要
Abstract
Objective HHcy is one of the independent risk factors for either cerebrovascular disease or cognitive impairment. The aim of this study is to investigate the relationship between blood Hcy level and early cognitive impairment in small vessel disease (SVD). Methods The data of SVD patients with no dementia from stroke clinic in our hospital for post-stroke follow-up were consecutively collected. The data included demographic information, vascular risk factors (VRFs) spectrum, cognitive assessment results and etc. The fasting blood Hcy was measured within 1 week after enrollment. HHcy was deflned as plasma Hcy level higher than 15 μmol/L. According to the Hcy test results, the patients were divided into HHcy group (Hcy>15?μmmol/L) and normal homocysteine (NHcy) group (Hcy≤15 μmol/L). Multimodal MRI was performed in all patients within 2 weeks after enrollment. The cognitive scores and imaging feature between the two groups were compared. The correlations of Hcy level with cognitive assessment results as well as with the imaging indices were analyzed. Results (1) A total of 81 SVD patients were enrolled in this study, with average age (64.3±7.4) years old, 65 male patients (80.2%) and 50 patients (61.7%) with mild cognitive impairment. (2) 30 patients (37.0%) in HHcy group and 51 ones (63.0%) in NHcy group. There were more smoking patients in HHcy than in NHcy group. There were no signiflcant difference in age, gender, education years between the two groups. (3) There were significant difference in the attention-executive function assessment such as trail making test B (TMT-B) (P=0.016), digital symbol substitution test (DSST) (P=0.013) and forward digital span test (DS-forward) (P=0.029) scores between the two groups. (4) The proportion of moderate to severe periventricular white matter lesions (PV-WMLs) (63.3% vs 39.2%, P=0.018), deep WMLs (60.0% vs 37.3%, P=0.036) and multiple cerebral microbleedings (CMBs) (36.7% vs 17.3%, P=0.047) in HHcy group were higher than those in NHcy group. The blood Hcy level was correlated with PV-WMLs (r=0.227, P=0.041). (5) After adjusting for PV-WMLs score, Hcy level was positively correlated with TMT-B time (r=0.278, P=0.013), negatively correlated with DSST (r=-0.354, P=0.004) and DS-forward (r=-0.366, P=0.001). Conclusions The blood Hcy level in SVD was signiflcantly correlated with attention-executive function and PV-WMLs. The blood Hcy level might be one of the markers of early cognitive impairment in SVD.关键词
脑小血管病/高同型半胱氨酸血症/认知功能/神经影像Key words
Small vessel disease/Hyperhomocysteinemia/Cognition/Neuroimaging引用本文复制引用
卢东,徐群,赵薇,杜静,耿介立,汪耀,曹雯炜,俞羚,支楠,周滟..脑小血管病患者外周血同型半胱氨酸水平与认知功能的相关性研究[J].中国卒中杂志,2019,(2):100-105,6.基金项目
科技部国家重点研发计划(2016YFC1300600)上海市科委"创新行动计划"基础研究项目(17JC404100) （2016YFC1300600）
