【摘要】 目的 探讨血清同型半胱氨酸(Hcy)与癫痫患者发作控制情况及认知功能损害的关系。方法 纳入明确诊断的癫痫患者128例,采用简易精神状态评价量表(MMSE)评价患者认知功能,根据患者是否存在轻度认知功能障碍(mild cognitive impairment,MCI)进行分组,其中MCI组46例,非MCI组82例。采用化学发光免疫分析方法测定患者血清中Hcy和叶酸、维生素B12水平,并采用Pearson相关分析患者血清Hcy水平和MMSE评分的相关性。给予合并高同型半胱氨酸血症(HHcy)癫痫患者叶酸、维生素B12治疗,统计患者治疗前、治疗3个月和6个月后血清Hcy水平和癫痫发作频率。结果 HHcy患者干预3个月和6个月后的血清Hcy水平均显著下降,癫痫发作频率显著减少(P<0.01);与非MCI组比较,MCI组血清叶酸和维生素B12水平显著降低(P<0.05),Hcy水平显著升高(P<0.01);当血清Hcy<15.00μmoL/L时,与MMSE无相关性(r=-0.18,P>0.05),当血清Hcy水平处于15.0～20.0μmol/L和>20.0μmol/L时,患者MMSE与血清Hcy水平呈负相关(r=-0.39、-0.56,P<0.05)。结论 对合并HHcy的癫痫患者,给予维生素B12干预,降低血清Hcy水平后,癫痫发作频率可降低;癫痫患者的Hcy水平是否可以作为癫痫患者MCI的生物预测指标仍需精确的分级研究。更多还原

【Abstract】 Objective To investigate the relationship between serum homocysteine（Hey） and seizure control as well as cognitive impairment in patients with epilepsy（MCI）. Methods A total of 128 cases of epilepsy patients were enrolled and assessed for cognitive function with Mini-Mental State Evaluation Scale（MMSE）. According to the existence of MCI, all the subjects were assigned into MCI group（n=46）, and non-MCI group（n=82）. The levels of folic acid, Hey, vitamin B₁₂ in serum of patients were determined by chemiluminescence immunoassay. The correlation between serum Hey and the score of MMSE were.analyzed by Pearson correlation analysis. High homocysteine（HHcy） epilepsy patients were treated with folic acid and vitamin B. The serum Hey level and the seizure frequency were analyzed before treatment, 3 months and6 months after treatment. Results The serum Hey level of HHcy patients at 3 months and 6 months after treatment decreased significantly, so as the seizure frequency（P < 0.01）. Compared with non-MCI group,serum folic level and vitamin B₁₂ decreased significantly（P<0.05）, while the Hey level increased（P<0.01）.When serum Hey was less than 15.00 μmol/L, there was no significant correlation with MMSE（r=-0.18, P >0.05）. When serum Hey level was between 15.0 ～20.0 μmol/L and over 20.0 μmol/L,there was a negative correlation between MMSE and serum Hey level（r=-0.39,-0.56; P < 0.05）. Conclusions Giving vitamin B₁₂intervention to HHcy epilepsy patients can reduce serum Hey levels and the frequency of seizures. Whether the level of Hey in epileptic patients can be used as a biological predictor of MCI in epileptic patients still needs to be classified accurately.更多还原