Hcy、UA与脑梗死脑白质病变严重程度及认知功能相关性研究

发布时间：2018-03-10 21:03

本文选题：脑梗死　切入点：脑白质病变　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨同型半胱氨酸(Hcy)、血尿酸(UA)水平与脑梗死患者脑白质病变(WMLs)严重程度及认识功能的相关性。方法:选取201选取同期脑梗死合并脑白质病变患者中的200例作为观察组,采用酶联免疫吸附法和尿酸氧化酶法分别检测两组患者血清中的Hcy、UA水平。将脑梗死合并脑白质病变患者根据TOAST分5年5月至2016年11月我院神经内科收治的脑梗死患者中的200例作为对照组,另外型进行分组,比较大动脉粥样硬化性脑梗死(LAA)、小动脉闭塞性脑梗死(SAO)和心源性脑梗死(CE)三组患者血清中的Hcy、UA水平,并采用北京版蒙特利尔认知评估量表(Mo CA)进行评分比较;将LAA、SAO和CE三组患者分别依据脑白质病变的严重程度分为轻度组、中度组和重度组,比较每个TOAST分型脑梗死不同病变程度患者血清中的Hcy、UA水平及Mo CA评分。对脑梗死合并脑白质病变患者持续治疗28d后,比较治疗前后患者血清中的Hcy、UA水平及Mo CA评分。结果:1、观察组患者血清中Hcy、UA水平均明显高于对照组,两组患者二者水平的差异均有统计学意义(P0.05)。2、不同TOAST分型脑梗死患者血清中Hcy、UA水平及Mo CA评分LAA组患者血清中Hcy、UA水平均明显高于SAO组和CE组患者,其差异均具有统计学意义(P0.05);而SAO组和CE组患者间的差异无统计学意义(P0.05)。三组患者的Mo CA评分差异无统计学意义(P0.05)。3、LAA型脑梗死患者血清中Hcy、UA水平均随脑白质病变的严重程度而升高,Mo CA评分则随脑白质病变的严重程度而减少,其差异亦均具有统计学意义(P0.05);SAO型脑梗死患者血清中Hcy、UA水平均随脑白质病变的严重程度而升高,Mo CA评分则随脑白质病变的严重程度而减少,其差异均具有统计学意义(P0.05);CE型脑梗死患者血清中Hcy、UA水平均随脑白质病变的严重程度而升高,Mo CA评分则随脑白质病变的严重程度而减少,其差异均具有统计学意义(P0.05)。4、CE型脑梗死患者血清中Hcy、UA水平均随脑白质病变的严重程度而升高,Mo CA评分则随脑白质病变的严重程度而减少,其差异均具有统计学意义(P0.05)。结论:脑梗死患者脑白质病变的严重程度随其血清中的Hcy、UA水平升高而加重,且其认知功能随患者血清中的Hcy、UA水平升高而降低,Hcy、UA水平与脑梗死患者脑白质病变的严重程度及认知功能存在相关性。
[Abstract]:Objective: to investigate the correlation between the level of homocysteine cystatin (HcyN) and serum uric acid (UAA) and the severity and cognitive function of white matter lesions (WMLs) in patients with cerebral infarction. Methods: 200 patients with cerebral infarction complicated with white matter disease were selected as the observation group. The serum levels of cyclosporin UA in patients with cerebral infarction and leukoencephalopathy were determined by Elisa and uric acid oxidase methods. According to TOAST, the patients were divided into 5 years from May to November 2016. The patients with cerebral infarction were treated in neurology department of our hospital from May to November 2016. 200 of the patients served as the control group, The other type was divided into three groups. The serum levels of Hcyanthera in the three groups of patients with Atherosclerotic cerebral infarction (ACA), arterio-occlusive cerebral infarction (SAO) and cardiogenic cerebral infarction (CEE) were compared, and the scores were compared with Beijing Montreal Cognitive Assessment scale (MOCA). According to the severity of white matter lesions, the patients in LAANASAO and CE groups were divided into three groups: mild group, moderate group and severe group. The serum levels of cystatin UA and MoCA were compared in patients with different degrees of cerebral infarction according to TOAST classification. After 28 days of continuous treatment, the patients with cerebral infarction complicated with white matter disease were treated continuously for 28 days. Results the serum levels of Hcylla in the observation group were significantly higher than those in the control group, and the scores of Mo CA in the patients before and after the treatment were compared with those in the control group. The difference between the two groups was statistically significant (P < 0.05). The serum levels of cystatin UA in patients with cerebral infarction of different TOAST classification and Mo CA score in LAA group were significantly higher than those in SAO group and CE group. There was no significant difference between SAO group and CE group (P 0.05). There was no significant difference in Mo CA score between the three groups. The increase of Mo CA score decreased with the severity of leukoencephalopathy. The difference was also statistically significant in the patients with P0.05 or SAO type cerebral infarction. The serum levels of Hcynica UA increased with the severity of white matter lesions, but the Mo CA scores decreased with the severity of white matter lesions. The differences were statistically significant. The serum levels of Hcynica in patients with CE type cerebral infarction were increased with the severity of leukoencephalopathy, and the scores of Mo CA were decreased with the severity of white matter lesions. The difference was statistically significant in patients with cerebral infarction of type P0.05. 4. The serum levels of Hcyn UA increased with the severity of white matter lesions, but the scores of Mo CA decreased with the severity of white matter lesions. Conclusion: the severity of cerebral white matter lesions in patients with cerebral infarction is aggravated by the increase of serum levels of cystatin UA. The cognitive function decreased with the increase of serum Hcynica level and correlated with the severity of cerebral white matter lesions and cognitive function in patients with cerebral infarction.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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