| ObjectiveTo investigate the effects of some vascular factors such as hypertension, coronary heart disease, diabetes, smoking history, drinking history, blood lipid, homocysteine, regional cerebral blood flow(rCBF) on the occurrence of Alzheimer's disease (AD) and Vascular dementia (VD) and to provide evidence for the early prevention and treatment of AD and VD.MethodsTotally 180 outpatients and 90 control group were recruited in this case-control study,while they were recorded detailed history questionnaire survey and accomplished the determination of blood lipid, blood sugar, folic acid, vitamin B12, homocysteine and regional cerebral blood flow. Compared Alzheimer's disease (AD) group and Vascular dementia (VD) group with control group about hypertension, coronary heart disease, diabetes, hyperlipidemia, smoking history, drinking history, blood lipid, folic acid, vitamin B12, homocysteine and regional cerebral blood flow. Date analyses were conducted with the Statistical Package for the Social Sciences(SPSS.V16.0).Results1. The age, sex, education degree of AD group, VD group and the control group were not statistically significant (P>0.05),while the dementia family history, MMSE total score, MoCA total score were significant differences (P<0.001) Vascular risk factors distribution:the hypertension, coronary heart disease, diabetes, and drinking history had distinctly different proportion between the three groups (P< 0.05)2 Vascular risk factors and AD:in multivariate analysis, hypertension, coronary heart disease were identified as risk faetors of AD. Hyperpietic was 2.31 times about no history of hypertension in the risk of happened AD,while cardiopath was 2.60 times about without coronary heart disease patients. The serum cholesterol, homocysteine of AD patients was higher than the control group,.while vitamin B12 was lower than that of the control group (P<0.05) 3 Vascular risk factors and VD:in multivariate analysis, hypertension, coronary heart disease and diabetes were identified as risk faetors of VD.Hyperpietic,cardiopath,diabetes respectively was 18.11 times,6.05 times,8.26 times about no history of hypertension, without coronary heart disease patients, diabetes in the risk of happened VD. The serum cholesterol, homocysteine of VD patients was higher than the control group,.while vitamin B12 was lower than that of the control group (P<0.05)4. Vascular risk factors of AD andVD:the hypertension and drinking history had distinctly different proportion between AD and VD (P<0.05). The coronary heart disease, diabetes, smoking history and Lipid levels were not statistically significant (P>0.05)5. SPECT results was shown:the regional cerebral blood flow of bilateral temporal lobe and parietal lobe of AD patients were lower than those of the control group (P<0.05),while bilateral the basal ganglia and bilateral thalamus blood perfusion no obvious change about the regional cerebral blood flow of AD patients (P >0.05). The left temporal lobe and left frontal lobe blood flow were lower than that of the right,while the parietal lobe and the occipital lobe were symmetrical about the regional cerebral blood flow. The mild AD patients can only performance for the left temporal lobe dysfunction, as the aggravating of dementia, involving bilateral temporal lobe and parietal lobe.The regional cerebral blood flow of the left temporal lobe,left frontal lobe and right thalamus of VD patients were lower than those of the control group (P<0.05) while that of the left were lower than that of the right (P<0.05)Conclusion1. Hypertension, coronary heart disease, diabetes, high cholesterol,high homocysteine level were identified as risk faetors of AD.2 Hypertension, coronary heart disease, diabetes, high cholesterol, high homocysteine level were identified as risk faetors of VD.3 AD and VD patients may exist common vascular risk factors:hypertension, coronary heart disease, diabetes,high cholesterol, high homocysteine. but VD patients with higher proportion than AD patients. 4 The regional cerebral blood flow of bilateral temporal lobe and parietal lobe of AD patients were obviously lower,while bilateral the basal ganglia and bilateral thalamus blood perfusion no obvious change. The left temporal lobe and left frontal lobe blood flow were lower than that of the right,while the parietal lobe and the occipital lobe were symmetrical about the regional cerebral blood flow. The mild AD patients can only performance for the left temporal lobe dysfunction, as the aggravating of dementia, involving bilateral temporal lobe and parietal lobe. AD patients left parietal lobe, left occipital lobe and MMSE was significantly positive correlation score.5. The regional cerebral blood flow of the left temporal lobe.left frontal lobe and right thalamus of VD patients were obviously lower,while that of the left were lower than that of the right.AD patients exist vascular risk factors, causing vascular lesions and blood flow, which could be confirmed by SPECT.VD patients have obvious vascular risk factors, especially the hypertension.Our results also identical with the reported in literature.Compared with the AD, VD patients have more vascular risk factors, especially hypertension.Therefore, control of blood pressure, blood sugar, blood fat, protect the heart, and improve blood supply to the brain actively were beneficial to prevent AD and VD. |
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