摘要：

目的 探讨阿尔茨海默病与血管性痴呆患者血浆同型半胱氨酸、血清尿酸和C-反应蛋白水平的差异。方法 分别采用直接化学发光法和酶法检测56 例阿尔茨海默病和122 例血管性痴呆患者血浆同型半胱氨酸、血清尿酸和C-反应蛋白表达水平，统计分析其表达差异。结果 阿尔茨海默病组［13.41（9.98，17.77）μmol/L］和血管性痴呆组［13.00（10.87，17.13）μmol/L］患者血浆同型半胱氨酸水平高于正常对照组［9.92（8.26，12.09）μmol/L，均P = 0.000］，阿尔茨海默病组患者血清C-反应蛋白水平［1.37（0.38，4.60）mg/L］低于正常对照组［4.55（1.55，8.40）mg/L，P  = 0.002］和血管性痴呆组［3.30（1.20，12.25）mg/L，P  = 0.006］。结论 血浆同型半胱氨酸可能是阿尔茨海默病和血管性痴呆的共同危险因素，改善高同型半胱氨酸血症将有助于延缓痴呆进程；检测血清C-反应蛋白水平对二者鉴别诊断亦具有一定临床价值。

关键词: 阿尔茨海默病, 痴呆, 血管性, 半胱氨酸, 尿酸, C 反应蛋白质

Abstract:

Objective To study the differences between Alzheimer's disease (AD) and vascular dementia (VaD) in the levels of plasma homocysteine (Hcy), serum uric acid (UA) and serum  C-reactive protein (CRP).  Methods  A total of 56 AD patients, 122 VaD patients and 100 healthy controls were enrolled in this study. The levels of plasma Hcy, serum UA and CRP were detected by direct chemiluminescence assay and enzymatic method, and analyzed among 3 groups.  Results  The plasma Hcy levels in AD group [13.41 (9.98, 17.77) μ mol/L] and VaD group [13.00 (10.87, 17.13) μ mol/L] were significantly higher than that in control group [9.92 (8.26, 12.09) μmol/L; P = 0.000, for all). The serum CRP levels in AD group [1.37 (0.38, 4.60) mg/L] were significantly lower than that in control group [4.55 (1.55, 8.40) mg/L, P  = 0.002] and VaD group [3.30 (1.20, 12.25) mg/L, P  = 0.006].  Conclusions  Plasma homocysteine might be the common risk factor for both AD and VaD, and hyperhomocysteinemia may accelerate the progression of dementia. Detection of C-reactive protein may help to differentiate AD and VaD in clinical practice.

Key words: Alzheimer disease, Dementia, vascular, Cysteine, Uric acid, C-reactive protein