脑白质疏松症患者情感淡漠与同型半胱氨酸水平的关系

Relationships among leukoaraiosis, apathy and homocysteine

摘要:

目的 研究脑白质疏松症（LA）患者情感淡漠发生率与同型半胱氨酸（tHcy）之间的关系。 方法 选取西南医科大学附属医院神经内科LA 患者和头颅影像无明显异常者作为LA 组和对照组，应用修订 版情感淡漠评定量表评估两组间情感淡漠发生率，并比较各组间tHcy 差异。结果 LA 组情感淡漠发生率高 于对照组（P <0.05），LA 组tHcy 水平较对照组高（P <0.05），中、重度LA 患者tHcy 水平高于轻度者（P <0.05）， 通过比较伴与不伴情感淡漠的LA 患者发现，前者血清tHcy 高于后者（P <0.05）。结论 LA 患者有着较高的 情感淡漠发生率，且tHcy 水平与LA 发生有着密切关系。LA 患者伴情感淡漠比不伴有更高的血清tHcy 水平。 tHcy 可能同时在LA 及情感淡漠的发生中发挥重要作用。

Abstract:

Objective To investigate the prevalence of apathy in patients with leukoaraiosis (LA), moreover, to analyze the possible relationships between those two and the plasma level of total homocysteine (tHcy). Methods Fourty-four patients with LA confirmed by magnetic resonance imaging and the same number of healthy controls were recruited from the Affiliated Hospital of Southwest Medical University. The Modified Apathy Evaluation Scale was used to identify whether there was apathy in the participants (score >14). Fasting venous blood was collected to assess the total plasma homocysteine level. At last, the possible relationships among leukoaraiosis, apathy and homocysteine were examined. Results The patients with leukoaraiosis had a higher prevalence of apathy than the healthy controls (P < 0.05). In addition, the tHcy level in the patients with LA was significantly higher than that in the control group (P < 0.05). Moreover, moderate or severe leukoaraiosis patients had obviously higher homocysteine levels than the patients with only mild leukoaraiosis (P < 0.05). In the participants with leukoaraiosis, the apathetic patients also had a significantly higher homocysteine level than those without apathy (P < 0.05). Conclusions First, leukoaraiosis patients are more likely to suffer from apathy compared to healthy people. Second, the total plasma homocysteine level is associated with the presence of leukoaraiosis, besides, it is related to the severity of white matter lesions. At last, there is an significantly higher homocysteine level in leukoaraiosis patients with apathy than those without apathy. Homocysteine may play a role in the presence of both leukoaraiosis and apathy.