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多梗死性痴呆患者血浆、脑脊液胰岛素含量与智能水平的相关性研究
Objective To study the change of plasma and cerebrospinal fluid (CSF) insulin levels and the relationship to intellectual level in patients with multi infarct dementia (MID).Methods The concentration of insulin in plasma and CSF was determined by RIAs in 55 patients with MID. 72 patients with cerebral infarction(CI) and 32 normal subjects were used as controls. Mini mental state examination (MMSE) was used to examine the intellectual level of patients, with DSM IV diagnosis standard and Hachinski Ischemia Score as references. Results The patients in MID had significantly higher plasma insulin level than that in normal controls ( P < 0.01 ), but lower CSF insulin and reduced CSF to plasma insulin ratio (P< 0.01). There was a positively correlated between CSF to plasma insulin ratio and MMSE score for MID as a whole. The patients in CI acute phase group had a higher plasma insulin levels than that in normal controls ( P < 0.05 ) , but CSF to plasma insulin ratio differed statistically from either MID acute episode group or stationary phase group ( P < 0.01 ). Conclusion The change of plasma and CSF insulin levels may be one of the pathophysiological mechanisms that bring about intellectual level decline in MID. CSF to plasma insulin ratio may be used as a marker of intellectual level declining for patients with MID.
