老年性痴呆与血清甲状腺激素及同型半胱氨酸水平的相关性研究
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- 论文作者：张彬彬 ; 娄伟 ; 侯宇 ; 马悦
- 年：2016
- 作者机构：辽宁省大连市第三人民医院;大连医科大学附属二院;
- 论文关键词：痴呆 ; 阿尔茨海默病 ; 血管性痴呆 ; 甲状腺激素 ; 同型半胱氨酸
- 英文论文关键词：dementia ; Alzheimer’s disease ; vascular dementia thyroid hormone homocysteine
- 会议召开时间：2016-11-25
- 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
- 语种：中文
- 分类号：R749.16
- 学会代码：HNZY
- 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
- 会议地点：中国广东珠海
- 主办单位：国际数字医学会、Digital Chinese Medicine
- 学会名称：湖南中医药大学期刊杂志社
- 页数：2
- 文件大小：1955k
- 原文格式：D
- 会议级别：全国
摘要
目的:探讨老年性痴呆患者血清中甲状腺激素(TH)及同型胱氨酸(Hcy)水平与疾病的关系。方法:选取大连市第三人民医院神经内科自2014年6月至2015年6月收治的75例老年痴呆患者作为试验组,根据Hachinski缺血指数量表评分法将该组患者的疾病类型分为阿尔茨海默病病(Alzheimer's disease,AD)组、混合性痴呆(mixeddementia,MD)组、血管性痴呆(vascular dementia,VD)组。同时根据简易精神状态检查量表(Mini-Mental State Examination,MMSE)评分将痴呆患者的严重程度分为轻度、中度及重度。另选同时期收治的同龄30例非老年痴呆患者作为对照(NC)组。对所有入选者进行血清TH包括:三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、共五项和同型半胱氨酸(Hcy)水平测定。TH检测采用化学发光法;Hcy检测采用酶循环法。对不同组分和临床不同分型的检测结果进行比较。结果:血清TH水平AD组、MD组、VD组与NC组相比较,T3、FT3、T4水平明显降低,具有统计学差异(P<0.01);而FT4、TSH水平变化不明显,没有统计学差异(P>0.05)。血清Hcy水平AD组、MD组、VD组与NC组相比较明显升高,具有统计学差异(P<0.01),Hcy浓度越高,认知功能损害的程度越重。结论:老年性痴呆患者血清中TH及Hcy水平与疾病的发生发展存在一定的相关性,甲状腺激素水平降低、血浆同型半胱氨酸水平升高可作为痴呆严重程度的间接指标,并能对临床诊断、防治及科研提供帮助。
Objective : To study the relationship between dementia and serum thyroid hormone and homocysteine(Hcy) levels.Methods:Seventy five cases with dementia in ourhospital from June 2014 to June 2015 were selected as a test group who were further divided into Alzheimer's disease group,mixed dementia group and vascular dementia group according tothescore of Hachinski Ischemic Scale,simultaneously divided into mild group,moderate group and severe group based on the Mini-Mental state Examination. Thirty patients without dementia werechosen as control group.Use chemiluminescence method to detect the triiodothyronine(T3), thyroxine(T4), supersensitive thyroid stimulating hormone(S-TSH),free triiodothyronine(FT3), and freethyroxine(FT4) in the blood serums of the patients,the level of homocysteine was detected with enzymatic cycling method and compared between the groups.Results: T3、FT3 and T4 inthe blood serums of the AD、MD、VD groups were distinctively lower than those in the blood serum of normal group(P <0.01).There was no obvious distinction of FT4 and TSH levels in the bloodserums(P>0.05). Mean total Hcy concentrations were significantly higher in AD.MD.VD patients than those in the patients with non-demented patients(P<0.01). The higher Hcyconcentration, the more severe of degree of cognitive dysfunction. Conclusion : Thyroid hormone and homocysteine levels are closely related to the occurrence and development of dementia, the reduction ofthyroiodine and levels of Hcy occur in dementia patients, and they may be indirect indicative factors for dementia severity and are helpful in the clinical diagnosis, prophylaxis and treatment, andscientific research.
Objective : To study the relationship between dementia and serum thyroid hormone and homocysteine(Hcy) levels.Methods:Seventy five cases with dementia in ourhospital from June 2014 to June 2015 were selected as a test group who were further divided into Alzheimer's disease group,mixed dementia group and vascular dementia group according tothescore of Hachinski Ischemic Scale,simultaneously divided into mild group,moderate group and severe group based on the Mini-Mental state Examination. Thirty patients without dementia werechosen as control group.Use chemiluminescence method to detect the triiodothyronine(T3), thyroxine(T4), supersensitive thyroid stimulating hormone(S-TSH),free triiodothyronine(FT3), and freethyroxine(FT4) in the blood serums of the patients,the level of homocysteine was detected with enzymatic cycling method and compared between the groups.Results: T3、FT3 and T4 inthe blood serums of the AD、MD、VD groups were distinctively lower than those in the blood serum of normal group(P <0.01).There was no obvious distinction of FT4 and TSH levels in the bloodserums(P>0.05). Mean total Hcy concentrations were significantly higher in AD.MD.VD patients than those in the patients with non-demented patients(P<0.01). The higher Hcyconcentration, the more severe of degree of cognitive dysfunction. Conclusion : Thyroid hormone and homocysteine levels are closely related to the occurrence and development of dementia, the reduction ofthyroiodine and levels of Hcy occur in dementia patients, and they may be indirect indicative factors for dementia severity and are helpful in the clinical diagnosis, prophylaxis and treatment, andscientific research.
引文
[1]刘爽,张玉莲,周震.老年性痴呆流行病学研究现况[J].中国老年学杂志,2010,30(10):1455-1457.
[2]Folstein MF,Folstein SE,Mc Hugh PR,et al.“min-Mental State”.Apractical method for grading the cognitive state of patients for theclinician[J].J Psychiatr Res,1975,12(3):189-198.
[3]Pantoni L,Inzitari D.Hachinski’s ischemic score and the diagnosis ofvascular dementia:a review[J].Ital J Neurol Sci,1993,14(7):539-546.
[4]Kapaki E,Paraskevas GP,Mantzou E,et al.Thyroidfunct ion inpatients with Alzheimer diseas e:Implicat ions on response to ant icholinesterase t reatment[J].Alzheimer Dis Associated Disor,2006,20(4):242-247.
[5]周智林,梁丽贞,严永兴.阿尔茨海默病和血管性痴呆患者甲状腺功能的研究.中华神经科杂志,2005;38(2):116-117.
[6]Chacon IJ,Molero AE,Pino-Ramirez G,et al.Risk of dementia associated with elevated plasma homocysteine in a latinamericanpopulation[J].Int J Alzheimers Dis,2009,814(3):670-677.
[7]王豪,瞿正万,倪培华,等.阿尔兹海默病血浆同型半胱氨酸水平与Apo E基因多态性关系研究[J].实用老年医学,2009,23(3):214-215.
[8]Minagawa H,Watanbe A,Akastu H,et al.Homocysteine,anotherrisk factor for Alzheimer diseasse,impairs apoliporotein E3 fuction[J].J Biol Chem,2010,285(49):1473-1474.
[9]李威,李昕华.高同型半胱氨酸血症与痴呆相关性研究[J].中国老年学杂志,2006,11(26):1473-1474.
[10]Alexopoulos P,Topalidis S,Irmisch G,et al.Homocysteineand cognitive function in geriatric depression[J].Neuropsychobiology,2010,61(20):97-104.
[2]Folstein MF,Folstein SE,Mc Hugh PR,et al.“min-Mental State”.Apractical method for grading the cognitive state of patients for theclinician[J].J Psychiatr Res,1975,12(3):189-198.
[3]Pantoni L,Inzitari D.Hachinski’s ischemic score and the diagnosis ofvascular dementia:a review[J].Ital J Neurol Sci,1993,14(7):539-546.
[4]Kapaki E,Paraskevas GP,Mantzou E,et al.Thyroidfunct ion inpatients with Alzheimer diseas e:Implicat ions on response to ant icholinesterase t reatment[J].Alzheimer Dis Associated Disor,2006,20(4):242-247.
[5]周智林,梁丽贞,严永兴.阿尔茨海默病和血管性痴呆患者甲状腺功能的研究.中华神经科杂志,2005;38(2):116-117.
[6]Chacon IJ,Molero AE,Pino-Ramirez G,et al.Risk of dementia associated with elevated plasma homocysteine in a latinamericanpopulation[J].Int J Alzheimers Dis,2009,814(3):670-677.
[7]王豪,瞿正万,倪培华,等.阿尔兹海默病血浆同型半胱氨酸水平与Apo E基因多态性关系研究[J].实用老年医学,2009,23(3):214-215.
[8]Minagawa H,Watanbe A,Akastu H,et al.Homocysteine,anotherrisk factor for Alzheimer diseasse,impairs apoliporotein E3 fuction[J].J Biol Chem,2010,285(49):1473-1474.
[9]李威,李昕华.高同型半胱氨酸血症与痴呆相关性研究[J].中国老年学杂志,2006,11(26):1473-1474.
[10]Alexopoulos P,Topalidis S,Irmisch G,et al.Homocysteineand cognitive function in geriatric depression[J].Neuropsychobiology,2010,61(20):97-104.