同型半胱氨酸、叶酸、维生素B12与阿尔茨海默病精神行为症状的相关性
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摘要
目的:探讨阿尔茨海默病(AD)患者的精神行为症状(BPSD)与同型半胱氨酸(Hcy)、叶酸、维生素B12的相关性。方法:选取40例伴有BPSD的AD患者和39例不伴BPSD的AD患者,以及39名正常对照者。分别测定所有被试的Hcy、叶酸及维生素B12水平并进行临床评估和认知评估。结果:3组研究对象血浆Hcy、叶酸、维生素B12水平存在差异,且差异有统计学意义(F=14.76,57.53,88.84;P<0.01)。两AD组患者血浆Hcy水平较正常对照组高,叶酸、VitB12水平较正常对照组低,差异有统计学意义(t=2.53,5.36,-8.68,-10.91,-13.39,-8.54;P<0.01),BPSD组较非BPSD组Hcy水平高,而VitB12水平低,差异有统计学意义(t=2.92,-4.28;P<0.01)。在两个患者组中,认知功能与Hcy水平呈负相关(r=-0.602;P<0.05),与维生素B12水平呈正相关(r=0.225;P<0.05)。结论:Hcy、叶酸、维生素B12水平与AD相关,Hcy、维生素B12可能参与了AD患者BPSD的发病机制。
Objective:To explore the relationship between behavioral and psychological symptoms of dementia and plasma homocysteine,folic acid and vitamin B12.Methods:A total of 40 alzheimer disease(AD)patients with BPSD,39 AD patients without BPSD,and 39 healthy controls were recruited in the study.All participants were tested the level of Hcy,folic acid,vitamin B12 and were assessed clinical symptoms and cognitive function.Results:The levels of plasma Hcy,folic acid and vitamin B12 in the 3 groups were different,and the difference was statistically significant(F=14.76,57.53,88.84;P<0.01).The level of Hcy in the two AD groups of patients were higher than that of normal control group;folic acid and VitB12 in the two AD groups were lower than that of the normal control group(t=2.53,5.36,-8.68,-10.91,-13.39,-8.54;P<0.01).The level of Hcy in group BPSD was higher than that in non BPSD group,but the level of VitB12 was low,and the difference was statistically significant(t=2.92,-4.28,P<0.01).In the two patients,the cognitive function was negatively correlated with the level of Hcy(r=-0.602;P<0.05),and was positively correlated with the level of vitamin B12(r=0.225;P<0.05).Conclusion:Hcy,folic acid and vitamin B12 are associated with AD.Hcy and vitamin B12 may take part in the pathogenesis of BPSD in AD.
Objective:To explore the relationship between behavioral and psychological symptoms of dementia and plasma homocysteine,folic acid and vitamin B12.Methods:A total of 40 alzheimer disease(AD)patients with BPSD,39 AD patients without BPSD,and 39 healthy controls were recruited in the study.All participants were tested the level of Hcy,folic acid,vitamin B12 and were assessed clinical symptoms and cognitive function.Results:The levels of plasma Hcy,folic acid and vitamin B12 in the 3 groups were different,and the difference was statistically significant(F=14.76,57.53,88.84;P<0.01).The level of Hcy in the two AD groups of patients were higher than that of normal control group;folic acid and VitB12 in the two AD groups were lower than that of the normal control group(t=2.53,5.36,-8.68,-10.91,-13.39,-8.54;P<0.01).The level of Hcy in group BPSD was higher than that in non BPSD group,but the level of VitB12 was low,and the difference was statistically significant(t=2.92,-4.28,P<0.01).In the two patients,the cognitive function was negatively correlated with the level of Hcy(r=-0.602;P<0.05),and was positively correlated with the level of vitamin B12(r=0.225;P<0.05).Conclusion:Hcy,folic acid and vitamin B12 are associated with AD.Hcy and vitamin B12 may take part in the pathogenesis of BPSD in AD.
引文
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[11]Engelborghs S,Vloeberghs E,Maertens K,et al.Correlations between cognitive,behavioural and psychological findings and levels of vitamin B12and folate in patients with dementia[J].Int J Geriatr Psychiatry,2004,19(4):365-370
[12]徐清,徐文炜,张玉琦,等.阿尔茨海默病与血浆同型半胱氨酸水平的相关性[J].中国健康心理学杂志,2014,22(10):1485-1486
[13]邓小莹,王延平,刘湘敏.叶酸、VitB12干预治疗对阿尔茨海默病患者血浆同型半胱氨酸水平的影响[J].中国实用神经疾病杂志,2012,15(4):35-37
[14]魏伟,刘恭平.叶酸和维生素B12有效改善阿尔茨海默样记忆障碍[J].华中科技大学学报,2012,41(4):453-456
[2]Pinidbunjerdkool A,Saengwanitch S,Sithinamsuwan P.Behavioral and psychological symptoms of dementia[J].J Med Assoc Thai,2014,97(Suppl 2):S168-174
[3]杨婵娟,张若曦,方雅秀,等.rTMS与利培酮治疗阿尔茨海默病患者精神行为症状的疗效观察[J].中国健康心理学杂志,2015,23(6):817-819+820
[4]李丽娜,赵璋,任璐璐,等.阿尔茨海默病患者照料者生命质量与社会支持的关系[J].中国健康心理学杂志,2017,25(3):383-386
[5]周田田,崔红梅,牛娟,等.同型半胱氨酸、叶酸、维生素B12与痴呆精神行为症状的研究进展[J].中国老年保健医学,2015,13(1):89-91
[6]Zhuo J M,Wang H,PraticòD.Is hyperhomncysteinemia an Alzheimer’s disease(AD)risk factor,an AD marker,or neither?[J].Trends Pharmacol Sci,2011,32(9):562-571
[7]王金东,郑占杰,孔伶俐,等.阿尔茨海默病精神障碍与叶酸和维生素B12的关系[J].国际老年医学杂志,2014,35(5):200-202+241
[8]Shen L,Ji H F.Associations between homocysteine,folic acid,vitamin B12and Alzheimer's disease:Insights from meta-analyses[J].J Alzheimers Dis,2015,46(3):777-790
[9]Kim G,Kim H,Kim K N,et al.Relationship of cognitive function with B vitamin status,homocysteine,and tissue factor pathway inhibitor in cognitively impaired elderly:A cross-sectional survey[J].J Alzheimers Dis,2013,33(3):853-862
[10]Zheng Z,Wang J,Yi L,et al.Correlation between behavioural and psychological symptoms of Alzheimer type dementia and plasma homocysteine concentration[J].Biomed Res Int,2014(1):1-6
[11]Engelborghs S,Vloeberghs E,Maertens K,et al.Correlations between cognitive,behavioural and psychological findings and levels of vitamin B12and folate in patients with dementia[J].Int J Geriatr Psychiatry,2004,19(4):365-370
[12]徐清,徐文炜,张玉琦,等.阿尔茨海默病与血浆同型半胱氨酸水平的相关性[J].中国健康心理学杂志,2014,22(10):1485-1486
[13]邓小莹,王延平,刘湘敏.叶酸、VitB12干预治疗对阿尔茨海默病患者血浆同型半胱氨酸水平的影响[J].中国实用神经疾病杂志,2012,15(4):35-37
[14]魏伟,刘恭平.叶酸和维生素B12有效改善阿尔茨海默样记忆障碍[J].华中科技大学学报,2012,41(4):453-456