慢性精神分裂症患者血清Hcy、血脂水平与认知障碍的关系

doi:10.3969/j.issn.1673-8640.2015.12.008

摘要/Abstract

摘要：

目的分析慢性精神分裂症患者血清同型半胱氨酸(Hcy)、血脂水平,探讨Hcy、血脂水平与认知功能之间的关系。方法分别测定154例慢性精神分裂症患者、60名健康志愿者(正常对照组)的Hcy、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。将慢性精神分裂症患者根据蒙特利尔认知评估量表(MoCA)评估结果分为认知障碍组和无认知障碍组,并对结果进行统计分析。结果认知障碍组Hcy、TC、TG、LDL-C水平均高于无认知障碍组和正常对照组(P均<0.05),HDL-C水平低于正常对照组(P<0.05)。单因素Logistic回归分析表明,Hcy、TC、TG、LDL-C是慢性精神分裂症患者认知损害的危险因素[比值比(OR)分别为1.114、1.791、2.141、1.556,95%可信区间(CI)分别为1.034~1.200、1.237~2.593、1.263~3.630、1.091~2.217]。多因素Logistic回归分析表明,Hcy是慢性精神分裂症患者认知损害的独立危险因素(OR=1.125,95%CI为1.040~1.217)。慢性精神分裂症患者血清Hcy水平与MoCA评分呈负相关(r=-0.362,P=0.000)。结论慢性精神分裂症患者的认知损害可能与血清Hcy水平升高和脂代谢异常有一定的关系。

关键词: 同型半胱氨酸, 血脂, 精神分裂症, 认知, 蒙特利尔认知评估量表

Abstract:

Objective To determine serum homocysteine(Hcy)and blood lipid, and to investigate the relationships of Hcy and blood lipid with cognitive function in patients with chronic schizophrenia.Methods The levels of Hcy, total cholesterol(TC), triglyceride (TG), high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C)were determined in 154 patients with chronic schizophrenia and 60 healthy subjects(healthy control group). The patients with chronic schizophrenia were classified into cognitive impairment group and non-cognitive impairment group according to the assessment of Montreal Cognitive Assessment (MoCA). The results were analyzed statistically. Results In cognitive impairment group, the levels of Hcy, TC, TG and LDL-C were significantly higher than those in non-cognitive impairment group and healthy control group(P<0.05), and the level of HDL-C was lower than that in healthy control group(P<0.05).Univariate Logistic regression analysis showed that Hcy,TC,TG and LDL-C were risk factors for cognitive impairment in patients with chronic schizophrenia [odds ratios(OR)were 1.114, 1.791, 2.141 and 1.556; 95% confidence intervals(CI)were 1.034-1.200, 1.237-2.593, 1.263-3.630 and 1.091-2.217]. Multivariate Logistic regression analysis showed that only Hcy was an independent risk factor for cognitive impairment in patients with chronic schizophrenia(OR=1.125, 95%CI was 1.040-1.217). Serum Hcy had negative correlation with MoCA score in patients with chronic schizophrenia(r=-0.362, P=0.000). Conclusions Cognitive impairment in patients with chronic schizophrenia may be associated with abnormal metabolism of Hcy and blood lipid.

Key words: Homocysteine, Blood lipid, Schizophrenia, Cognition, Montreal Cognitive Assessment

中图分类号:

R446.1

王晓燕, 王伟灵, 丁彬彬, 陈淑蓉, 张素琴, 朱光, 罗碧明, 汪作为. 慢性精神分裂症患者血清Hcy、血脂水平与认知障碍的关系[J]. 检验医学, 2015, 30(12): 1198-1202.

WANG Xiaoyan, WANG Weiling, DING Binbin, CHEN Shurong, ZHANG Suqin, ZHU Guang, LUO Biming, WANG Zuowei. The correlation between serum levels of Hcy, blood lipid and cognitive disorder in patients with chronic schizophrenia[J]. Laboratory Medicine, 2015, 30(12): 1198-1202.

图/表 4

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组别	例数	MoCA总分	年龄(岁)	病程(年)	Hcy(μmol/L)
认知障碍组	120	21.51±3.14^*#	54(27~60)	23.21±10.71	23.24±14.35^*#
无认知障碍组	34	26.56±0.66	53(26~60)	21.18±9.59	15.25±6.74
正常对照组	60	27.72±0.94	54(28~60)	-	12.68±2.02
组别	TC(mmol/L)	TG(mmol/L)	HDL-C(mmol/L)	LDL-C(mmol/L)
认知障碍组	4.93±1.22^*#	2.25±1.83^*#	1.15±0.28^*	3.56±1.19^*#
无认知障碍组	4.39±0.96	1.37±0.76	1.24±0.36	3.10±0.92
正常对照组	4.20±0.71	1.29±0.28	1.35±0.26	3.03±0.81

组别	例数	MoCA总分	年龄(岁)	病程(年)	Hcy(μmol/L)
认知障碍组	120	21.51±3.14^*#	54(27~60)	23.21±10.71	23.24±14.35^*#
无认知障碍组	34	26.56±0.66	53(26~60)	21.18±9.59	15.25±6.74
正常对照组	60	27.72±0.94	54(28~60)	-	12.68±2.02
组别	TC(mmol/L)	TG(mmol/L)	HDL-C(mmol/L)	LDL-C(mmol/L)
认知障碍组	4.93±1.22^*#	2.25±1.83^*#	1.15±0.28^*	3.56±1.19^*#
无认知障碍组	4.39±0.96	1.37±0.76	1.24±0.36	3.10±0.92
正常对照组	4.20±0.71	1.29±0.28	1.35±0.26	3.03±0.81

组别	例数	视空间与执行功能	命名	记忆力
高Hcy组	100	2.84±1.01^*	2.87±0.34	3.05±1.37
Hcy正常组	54	3.72±1.05	2.91±0.35	3.43±1.16
组别	注意力	语言表达	抽象能力	定向力
高Hcy组	3.78±1.07^*	0.96±0.71	0.80±0.79	5.53±0.69
Hcy正常组	4.85±0.90	1.02±0.72	1.00±0.93	5.67±0.51

组别	例数	视空间与执行功能	命名	记忆力
高Hcy组	100	2.84±1.01^*	2.87±0.34	3.05±1.37
Hcy正常组	54	3.72±1.05	2.91±0.35	3.43±1.16
组别	注意力	语言表达	抽象能力	定向力
高Hcy组	3.78±1.07^*	0.96±0.71	0.80±0.79	5.53±0.69
Hcy正常组	4.85±0.90	1.02±0.72	1.00±0.93	5.67±0.51

组别	例数	视空间与执行功能	命名	记忆力
高脂血症组	92	2.91±0.91^*	2.86±0.35	2.60±1.29^*
血脂正常组	62	3.98±0.95	2.92±0.33	3.56±1.18
组别	注意力	语言表达	抽象能力	定向力
高脂血症组	4.32±1.07	0.92±0.72^*	0.62±0.87	5.58±0.68
血脂正常组	4.56±1.03	1.25±0.69	0.86±0.90	5.58±0.56