2025 年第 6 期 第 20 卷

血浆金属元素与痰湿质老年人认知功能的关联研究

Association between plasma metal elements and cognitive function in the elderly with phlegm-dampness constitution

作者：许苗苗1苏莉2钱晓华3覃瑞1卢黎明1古联4

英文作者：Xu Miaomiao1 Su Li2 Qian Xiaohua3 Qin Rui1 Lu Liming1 Gu Lian4

单位：1广西中医药大学，南宁530200；2广西医科大学公共卫生学院，南宁530021；3上海交通大学生物医学工程学院，上海200030；4广西中医药大学附属瑞康医院脑病科二区，南宁530011

英文单位：1Guangxi University of Chinese Medicine Nanning 530200 China; 2School of Public Health Guangxi Medical University Nanning 530021 China; 3School of Biomedical Engineering Shanghai Jiao Tong University Shanghai 200030 China; 4Second Ward Department of Brain Disease Ruikang Hospital Affiliated to Guingxi University of Chinese Medicine Nanning 530011 China

关键词：认知功能；血浆金属元素；中医体质；关联研究

英文关键词：Cognitivefunction;Plasmametalelements;TraditionalChinesemedicineconstitution;Associationstudy

• 摘要：

• 目的 探讨血浆金属元素与痰湿质老年人认知功能之间的关联，为痰湿体质的老年人认知功能损害的防治提供一定的科学依据。方法 2020年6月至2023年6月共纳入73例广西壮族自治区南宁市某社区的痰湿质老年人为研究对象；采用简易精神状态检查量表（MMSE）对研究对象的认知功能进行评估；此外测定血浆中金属元素的浓度（取四分位数分为Q1组、Q2组、Q3组、Q4组，比对时以Q1组为参考），采用Spearman相关性分析和多元线性回归探讨血浆金属浓度与认知功能间的关联。结果 相关性分析结果显示，血浆钴浓度与记忆力评分呈正相关（r=0.233，P=0.048）；血浆铜浓度与MMSE总分、记忆力、语言和实践能力评分呈负相关（r=-0.232，P=0.048；r=-0.245，P=0.037；r=-0.375，P=0.001）；血浆铷与记忆力评分呈负相关（r=-0.240，P=0.041）。多元线性回归结果显示，血浆铜与MMSE总分呈负相关［Q4组比Q1组：线性回归系数(β)=-2.480，95%置信区间：-4.725～-0.235，连续变量β=-0.270，95%置信区间：-0.488～-0.052，P<0.05］。血浆钴与记忆力评分呈正相关(Q4组比Q1组：β=0.488，95%置信区间：0.086～0.890，P趋势=0.039，连续变量：β=0.018，95%置信区间：0.001～0.035，P<0.05)。血浆铜浓度与记忆力评分呈负相关(Q3组比Q1组：β=-0.421，95%置信区间：-0.823～-0.019，P<0.05)。当血浆铷作为连续变量时与记忆力评分呈负相关（β=-0.045，95%置信区间：-0.084～-0.006，P<0.05）。血浆铜与语言和实践能力评分呈负相关（Q3组比Q1组：β=-0.901，95%置信区间：-1.765～-0.038，P<0.05；Q4组比Q1组： β=-1.184，95%置信区间：-2.060～-0.308，P<0.01，P趋势=0.007，连续变量：β=-0.120，95%置信区间：-0.206～-0.034，P<0.01)。结论 血浆钴可能是痰湿质老年人认知功能的保护因素，而血浆铜和铷是痰湿质老年人认知功能的危险因素，可为痰湿质老年人认知功能损害的防治提供一定的参考依据。

• Objective To explore the relationship between plasma metal elements and cognitive function in the elderly with phlegm-dampness constitution, and to provide a scientific basis for the prevention and treatment of cognitive impairment in the elderly with phlegm-dampness constitution. Methods From June 2020 to June 2023, a total of 73 elderly people with phlegm-dampness constitution in a community in Nanning City, Guangxi Zhuang Autonomous Region were enrolled as the research objects. The mini mental state examination (MMSE) was used to evaluate the cognitive function of the subjects. In addition, the plasma concentrations of metal elements were measured (the quartile was divided into Q1 group, Q2 group, Q3 group, and Q4 group, and Q1 group was used as a reference for comparison). Spearman correlation analysis and multiple linear regression were used to explore the association between plasma metal concentrations and cognitive function. Results Correlation analysis showed that plasma cobalt concentration was positively correlated with memory score (r=0.233, P=0.048); the plasma copper concentration was negatively correlated with MMSE total score, memory, language and practical ability scores (r=-0.232, P=0.048; r=-0.245, P=0.037; r=-0.375, P=0.001); the plasma rubidium was negatively correlated with memory scores (r=-0.240, P=0.041). The results  of multiple linear regression showed that plasma copper was negatively correlated with MMSE score ［Q4 group vs Q1 group: linear regression coefficient(β)=-2.480, 95% confidence interval(CI):-4.725 to -0.235, continuous variable β=-0.270, 95%CI: -0.488 to -0.052, P<0.05］. The plasma cobalt was positively correlated with memory score (Q4 group vs Q1 group: β=0.488， 95%CI: 0.086 to 0.890, Ptrend=0.039, continuous variable: β=0.018, 95%CI: 0.001 to 0.035, P<0.05). The plasma copper concentration was negatively correlated with memory score (Q3 group vs Q1 group: β=-0.421， 95%CI:-0.823 to -0.019, P<0.05). The plasma rubidium was negatively correlated with memory scores when used as a continuous variable (β=-0.045, 95%CI:-0.084 to -0.006, P<0.05). The plasma copper was negatively correlated with language and practical ability scores (Q3 group vs Q1 group: β=-0.901, 95%CI: -1.765 to -0.038, P<0.05; Q4 group vs Q1 group: β=-1.184, 95%CI:-2.060 to -0.308, P<0.01, Ptrend=0.007, continuous variable: β=-0.120， 95%CI: -0.206 to -0.034， P<0.01). Conclusion Plasma cobalt may be a protective factor for cognitive function in the elderly with phlegm-dampness constitution, while plasma copper and rubidium are risk factors for cognitive function in the elderly with phlegm-dampness constitution, which can provide a reference for the prevention and treatment of cognitive impairment in the elderly with phlegm-dampness constitution.