The Study Of The Levels Of ADMA, Hcy And The Correlation In Patients With Vascular Cognition Impairment

Objectives:To observe the level of plasma asymmetric dimethylarginine(ADMA) and homocysteine(Hcy) and serum nitric oxide(NO) in patients with vascular dementia(VD) and non-dementia vascular cognitive impairment(VCIND),we study the influence of ADMA,Hcy and NO on vascular cognitive impairment and the correlation among them.Meanwhile,we analyze the electrophysiological features of event-related potential P300(ERP-P300),as well as the relations ADMA,Hcy and NO with the VCI,ERP-P300,in order to provide theoretical foundations for the prevention,early diagnosis and therapy of VCI.Methods:The patients in neurology department of 120 cases of cerebral infarction were selected in our hospital from May 2007～July 2008,who are in line with the 1995 Fourth National Symposium on Cerebrovascular Diseases revised diagnostic criteria.They are divided into three groups according to the level of cognition(40 cases each group),vascular dementia group(VD group),non-dementia vascular cognitive impairment group(VCIND group) and control group(cerebral infarction with normal cognition).High performance liquid chromatography(HPLC) was used to detect the level of plasma ADMA and Hcy in patients with vascular cognitive impairment.Nitrate reduction colorimetric enzyme was used to detect the level of serum NO.Neuropsychology scales such as Mini-mental State Examination(MMSE), Hamilton Depression Rating Scale(HAMD),Clinical Dementia Rating(CDR), Hachinski Ischemic Index Scale and the United States National Institutes of Health Stroke Scale(NIHSS) were applied to evaluate of patients.NDI-200 EMG evoked potential instrument was used to test auditory ERP-P300,using oddball stimulus sequence,according to the international 10-20 system EEG Society placed electrodes in patients.TBA-120FR automatic biochemical analyzer was applied for general laboratory data.Results:1.Plasma levels of ADMA in VD group,VCIND group and the control group were respectively(0.865±0.152)μmol / L,(0.725±0.110)μmol / L,(0.402±0.122)μmol/L.Plasma levels of Hcy were(41.052±8.677)μmol / L,(27.518±7.420) μmol / L,(20.944±8.943)μmol / L.Serum levels of NO were(26.41±8.45)μmol / L,(45.54±12.96)μmol / L,(73.78±11.63)μmol / L.Compared with the control group and VCIND group,VD group plasma levels of ADMA,Hcy were significantly increased,and serum levels of NO were significantly reduced. Compared with the control group,VCIND group plasma levels of ADMA,Hcy were significantly increased,and serum levels of NO were significantly decreased. These differences were statistically significant(P<0.05).Indicating that ADMA, Hcy were closely related to cognitive dysfunction.2.The correlation analyses revealed that ADMA and Hcy were positively correlated, ADMA and NO were negatively correlated,Hcy was negatively correlated with NO.They were statistical significance(P<0.05).3.P300 latency of VD group,VCIND group and the control group were respectively (386.85±19.28)ms,(351.20±15.94) ms,(327.36±17.65) ms,P300 amplitude respectively(4.37±2.84)μv,(5.98±2.64)μv,(6.81±2.30)μv,MMSE score (19.48±2.94),(25.73±2.97),(29.40±2.12).Compared with the control group and VCIND group,VD group were significantly prolonged in P300 latency,P300 amplitude decreased significantly(P<0.05).Compared with the control group, VCIND group were significantly prolonged P300 latency(P<0.05),but no signifi -cant difference between P300 amplitude decreased(P>0.05).4.Using Spearman correlation analysis,ADMA,Hcy levels and MMSE scores were negative,positively correlated with P300 latency(P<0.05).NO and MMSE score was positive,negatively correlated with P300 latency(P<0.05),but ADMA,Hcy and NO showed no correlation with P300 amplitude(P>0.05).Indicated that ADMA,Hcy may be related to the degree of cognitive dysfunction.5.Cerebral infarction size and location and cognitive impairment have certain relevance,but the size and site of cerebral infarction and plasma ADMA,Hcy levels had no correlation.6.Multiple regression analysis revealed that ADMA,Hcy levels may be predictors of vascular cognitive dysfunction.Conclusions: The levels of plasma ADMA,Hcy were increased in patients with VCI.ADMA were positively correlated with Hcy.Indicating that ADMA,Hcy are closely related with the VCI.ERP-P300 can objectively reflect the degree of cognitive impairment on the VCI,which has clinical diagnostic value of VCI.ADMA,Hcy levels may be associated with the degree of vascular cognitive dysfunction and ERP-P300 relevant. Cerebral infarction size and location and cognitive dysfunction has certain relevance, but cerebral infarction size and location had no correlation with plasma ADMA,Hcy levels.Plasma ADMA,Hcy levels may be an independent predictor of vascular cogni -tive dysfunction.