CAJ | 학술논문

目的探讨重金属在阿尔茨海默病(Alzheimer's disease,AD)和血管性痴呆(vascular dementia,VaD)发病过程中的作用,分析AD患者认知功能障碍与血浆重金属含量的关系.方法纳入50例AD患者、20例VaD患者和20例正常对照者,AD患者按临床痴呆分级量表(Clinical Dementia Rating,CDR)分为轻度痴呆组(CDR=1分)和中重度痴呆组(CDR=2～3分).所有观察对象均行简易智能状态量表(Mini-Mental State Examination,MMSE)、Hachinski缺血指数评分和CDR评分,同时抽取空腹静脉血检测重金属(Cu、Ca、Fe、Me、Zn、Hg、Cr、Co、Se和Pb)的浓度.结果与对照组比较,轻度AD组和中重度AD组血浆Cu浓度显著增高[分别为(0.66±0.21)、(0.84±1.11)和(0.85±1.12)ng/g,P＜0.05],轻度AD组与中重度AD组之间无显著差异.对照组Pb浓度显著低于中重度AD组[(22.79±3.94)ng/g对(40.82±16.96)ng/g,P＜0.05],而对照组与轻度AD组以及轻度AD组与中重度AD组之间均无显著差异.AD组血浆Cu浓度[(0.84±1.25)ne/g对(0.66 ±0.21)ng/g,P＜0.05]和Pb浓度[(32.42±14.12)ne/g对(22.79±3.94)ng/g,P＜0.05]均显著高于对照组,而VaD组与对照组之间金属浓度均无显著差异,VaD组和AD组之间的金属浓度亦无显著差异.结论部分重金属,如Cu和Pb可能参与了AD的发病过程,但重金属浓度与VaD的发病关系不大,AD患者的认知障碍程度与血浆金属浓度无显著相关性.
목적 탐토중금속재아이자해묵병(Alzheimer's disease,AD)화혈관성치태(vascular dementia,VaD)발병과정중적작용,분석AD환자인지공능장애여혈장중금속함량적관계.방법 납입50례AD환자、20례VaD환자화20례정상대조자,AD환자안림상치태분급량표(Clinical Dementia Rating,CDR)분위경도치태조(CDR=1분)화중중도치태조(CDR=2～3분).소유관찰대상균행간역지능상태량표(Mini-Mental State Examination,MMSE)、Hachinski결혈지수평분화CDR평분,동시추취공복정맥혈검측중금속(Cu、Ca、Fe、Me、Zn、Hg、Cr、Co、Se화Pb)적농도.결과 여대조조비교,경도AD조화중중도AD조혈장Cu농도현저증고[분별위(0.66±0.21)、(0.84±1.11)화(0.85±1.12)ng/g,P＜0.05],경도AD조여중중도AD조지간무현저차이.대조조Pb농도현저저우중중도AD조[(22.79±3.94)ng/g대(40.82±16.96)ng/g,P＜0.05],이대조조여경도AD조이급경도AD조여중중도AD조지간균무현저차이.AD조혈장Cu농도[(0.84±1.25)ne/g대(0.66 ±0.21)ng/g,P＜0.05]화Pb농도[(32.42±14.12)ne/g대(22.79±3.94)ng/g,P＜0.05]균현저고우대조조,이VaD조여대조조지간금속농도균무현저차이,VaD조화AD조지간적금속농도역무현저차이.결론 부분중금속,여Cu화Pb가능삼여료AD적발병과정,단중금속농도여VaD적발병관계불대,AD환자적인지장애정도여혈장금속농도무현저상관성.
Objective To investigate the roles of heavy metals in the onset of Alzheimer 's disease (AD) and vascular dementia (VaD) and to analyze the relationship between cognitive impairment and plasma heavy metal concentrations in patients with AD. Methods Fifty patients with AD, 20 with VaD, and 20 healthy controls were included in the study. According to the Clinical Dementia Rating (CDR), the AD patients were divided into mild dementia (CDR = 1 )and moderate to severe dementia (CDR = 2 to 3 ) groups. All the observational subjects performed the Mini-Mental State Examination (MMSE) score, Hachinski ischemic index score,and CDR score. A fasting venous blood sample was taken from all the subjects for detection of the heavy metal (Tu, Ca, Fe, Me, Zn, Hg, Cr, Co, Se, and Pb) concentrations at the same time.Results Compared to the control group, the plasma Cu concentration in the mild dementia and moderate to severe dementia groups increased significantly (0. 66 ± 0. 2 1, 0. 84 ± 1.11, and 0. 85 ± 1.12 ng/g, respectively (P ＜ 0. 05). There was no significant difference between the mild AD group and the moderate to severe dementia group. The Pb concentration in the control group was significantly lower than that in the moderate to severe dementia group (22.79 ±3.94 ng/gvs. 40. 82 ± 16.96 ng/g, P ＜ 0. 05 ). While there were no significant differences between the control and the mild dementia and moderate to severe dementia groups. The plasma Cu concentration (0.84 ± 1.25 ng/g vs. 0. 66 ± 0.21 ng/g, P ＜＜ 0. 05) and Pb concentration (32.42 ± 14. 12 ng/gvs. 22.79 ± 3.94 ng/g, P ＜ 0. 05) in the AD group were significantly higher than that in the control group. While there was no significant difference between the VaD group and the control group for metal concentrations. There was also no significant difference for metal concentrations hetween the VaD group and the AD group. Conclusions Some heavy metals, such as Cu and Pb might have participated in the pathogenic process of AD, but the heavy metal concentrations did not have close relationship with the onset of VaD. There was no significant correlation between the degree of cognitive impairment and the plasma metal concentrations in patients with AD.