Abstract:

Objective To explore the association of homocysteine with mild cognitive impairment in hypertension patients. Methods Data of primary hypertension patients from Department of Neurology of Handan First Hospital between January 2017 and February 2018 were retrospectively analyzed. According to the level of plasma homocysteine (Hcy), the patients were divided into 2 groups: none-H-type hypertension group (Hcy<15 μmmol/L) and H-type hypertension group (Hcy≥15 μmmol/L). The MMSE and MoCA score were used to evaluate the cognitive function of these patients. Spearman correlation analysis was used to determine the relationship between plasma Hcy and MMSE and MoCA, and logistic regression analysis was used to determine the influencing factors for mild cognitive impairment. Results 113 subjects were included, with 49 cases in none-H-type hypertension group and 64 cases in H-type hypertension group. In comparison to none-H-type hypertension group, H-type hypertension group had lower MMSE score (24.94±1.83 vs 27.96±1.54, P <0.001) and MoCA score (23.45±2.47 vs 27.24±1.80, P <0.001). The correlation analysis showed that Hcy level was negatively correlated with the MMSE score (r =-0.513, P <0.001) and MoCA score (r =-0.500, P <0.001). Logistic analysis showed that higher age (OR 1.236, 95%CI 1.124-1.361) and H-type hypertension (OR 22.218, 95%CI 8.243-59.654) were the independent risk factors for cognitive impairment. Conclusions Higher plasma Hcy level was the independent risk factor for mild cognitive impairment in hypertension patients.

Key words: H-type hypertension; Homocysteine; Mild cognitive impairment

摘要：

目的 探讨同型半胱氨酸（homocysteine，Hcy）与高血压患者轻度认知障碍的相关性。 方法 回顾性纳入2017年1月-2018年2月邯郸市第一医院神经内科连续收治的原发性高血 压患者，根据其血浆Hcy水平，将患者分为单纯型高血压组（Hcy<15 μm m ol/L）与H型高血压组 （Hcy≥15 μmmol/L），采用Spearman秩相关分析Hcy与MMSE和MoCA评分的相关性，并采用Logistic回归 分析高血压患者轻度认知功能障碍的影响因素。 结果 共纳入原发性高血压患者113例，其中单纯型高血压组49例，H型高血压组64例。H型高血压 组患者的MMSE和MoCA评分均低于单纯型高血压组（分别为24.94±1.83 vs 27.96±1.54和23.45±2.47 vs 27.24±1.80，均P <0.001）。相关分析显示，Hcy水平与MMSE和MoCA评分存在负相关性（分别为r =- 0.513和r =-0.500，均P＜0.001）。多因素Logistic回归分析显示，高龄（OR 1.236，95%CI 1.124～1.361）、 H型高血压（OR 22.218，95%CI 8.243～59.654）是高血压患者轻度认知功能障碍的独立危险因素。 结论 Hcy水平升高是高血压患者轻度认知功能障碍发生的独立危险因素。

关键词: H型高血压; 同型半胱氨酸; 轻度认知功能障碍