摘要
目的评价合并高同型半胱氨酸血症(Hhcy)的脑白质疏松症(LA)患者的认知功能,观察甲钴胺干预治疗后认知功能的变化。方法选择合并Hhcy的LA患者100例为甲组,无Hhcy的LA患者90例为乙组,甲组予基础治疗的同时,予甲钴胺干预治疗12周,乙组仅给予基础治疗12周,观察干预前后两组血浆Hcy水平及简易精神状态量表(MMSE)、Hachinski缺血积分(HIS)、临床痴呆评定量表(CDR)、日常生活能力量表(ADL)、总体衰退量表(GDS)评分的变化。结果随着LA程度的加重,甲乙两组患者的认知功能均下降(P<0.01),在中重度白质病变患者组,甲组MMSE、HIS、ADL、GDS评分与乙组相比较差异有统计学意义(P<0.01)。甲组经甲钴胺干预治疗12周后血浆Hcy水平下降至正常范围,认知障碍评分有好转趋势,中度白质病变患者组中HIS、GDS评分较干预治疗前下降(P<0.01),重度白质病变患者组中MMSE、ADL、GDS评分较干预治疗前下降(P<0.01)。结论随着LA程度的加重,合并Hhcy的LA患者较单纯LA患者的认知功能明显下降,予甲钴胺治疗后血浆Hcy水平降至正常范围,认知功能有所改善。
Objective To evaluate the cognitive function in patients with leukoaraiosis(LA) complicated with hyperhomocysteinemia(Hhcy),and to observe the changes of cognitive function after mecobalamin intervention.Methods 100 LA patients complicated with Hhcy were selected as group A,and 90 LA patients without Hhcy were selected as group B.The group A were treated with mecobalamin for 12 weeks on the basis of basic therapy,while the group B were only given basic therapy for 12 weeks.And then,the changes of plasma Hcy level and mini-mental state scale(MMSE),Hachinski ischemic score(HIS),clinical dementia rating scale(CDR),activity of daily living scale(ADL) and global decline scale(GDS) before and after intervention were observed between the two groups.Results The cognitive functions of both group A and group B decreased with the aggravation of LA(P<0.01).There was a statistically significant difference in MMSE,HIS,ADL and GDS scores between the group A and the group B in patients with moderate or severe white matter lesions(P<0.01).In the group A,the level of plasma Hcy decreased to normal range after 12 weeks of mecobalamin treatment,and the cognitive impairment score showed a trend of improvement,the HIS and GDS scores in patients with moderate white matter lesions were lower than those before intervention(P<0.01),and the MMSE,ADL and GDS scores in patients with severe white matter lesions were lower than those before intervention(P<0.01).Conclusion With the aggravation of LA,the cognitive function of LA patients with Hhcy was significantly lower than that of LA patients without Hhcy.After mecobalamin treatment,plasma Hcy level decreases to normal range,and the cognitive function improves.
作者
杨茜
黄振宇
陈红
高文
黄广苏
陈笠
陈炜
王栋慧
YANG Qian;HUANG Zhenyu;CHEN Hong;GAO Wen;HUANG Guangsu;CHEN Li;CHEN Wei;WANG Donghui(Department of Neurology,Liuzhou General Hospital,Liuzhou 545006,China)
出处
《右江医学》
2019年第2期86-91,共6页
Chinese Youjiang Medical Journal
基金
广西壮族自治区卫生厅自筹经费科研课题(Z2012564)
