Correlation Between Homocysteine And Mild Cognitive Impairment In Patients With COPD

Objective To explore the relationship between chronic obstructive pulmonary disease（COPD）with mild cognitive impairment（MCI）and homocysteine（Hcy）.Methods The 149 stable COPD patients,were randomly selected as objects of study.These patients were outpatient and inpatient in the frist department of geriatrics during November 2017 to January 2019.According to the Montreal Cognitive Assessment（MoCA）and the Activity of Daily Living Scale（ADL）to evaluate their cognitive impairment,the patients were divided into observation group（COPD with MCI）and control group（simple COPD）.To explore the correlation between the total score of MoCA and plasma Hcy Level by comparing Hcy with MoCA scores.According to the GOLD classification of lung function,the observation group was divided into mild group,moderate group and severe group to discuss the effect of different degrees of lung function on the total score of MoCA.Statistical analysis of collected data using SPSS 22.0.Results 1.The difference of age,smoking history,education,Hcy,cystatin C,uric acid,PO₂ and FEV₁%pred were statistically significant（P<0.05）,the age,smoking history and Hcy,CysC of the observation group were higher than those of the control group,while the educational level and UA,PO₂,FEV₁%pred of the observation group were lower than those of the control group.2.The difference in total MoCA score between the three groups was statistically significant（P<0.05）,the lower the FEV₁%pred,the lower the total score of MoCA.3.There were 70 cases of HHcy in COPD patients,including 54 cases（77.1%）in the observation group and 16 cases（22.9%）in the control group.There was significant difference between the two groups.（X²=29.204,P<0.05）.4.According to the pearson-related analysis of the two groups of data,the age,Hcy,cystatin C and total scores of MoCA were negatively correlated（R=-0.161,R=-0.723,R=-0.549,P<0.05）;The uric acid,PO₂,FEV₁%pred and total scores of MoCA were all positively correlated（R=0.378,R=0.269,R=0.682,P<0.05）.5.Using logistic regression to analyze its influencing factors,we found that age,Hcy,and cystatin C were risk factors for MCI in COPD patients.Conclusion 1.age,smoking history,educational level,cystatin C,uric acid,PO2 were associated with MCI in COPD patients,older age,smoking,low educational level,high cystatin C level,low uric acid level and low PO₂ level were more likely to develop MCI in COPD patients.2.The heavier the lung function damage,the lower the MoCA score.3.The higher the level of Hcy in COPD patients,the more likely to develop MCI,When the Hcy level is higher than 15umol/l,the probability of MCI is higher.4.Hcy,cystatin C is a risk factor for MCI in patients with COPD,suggesting that Hcy,cystatin C can be used as a predictor of MCI in patients with COPD.