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目的:探讨血清高密度脂蛋白（HDL）、同型半胱氨酸（Hcy）的表达与双相障碍躁狂发作女性患者认知功能的关系。方法:选取2019年12月至2020年12月于湛江市第三人民医院就诊的双相障碍躁狂发作女性患者67例作为观察组，再选取67例同时期在湛江市第三人民医院进行健康体检女性作为对照组。观察组年龄（33.76±8.42）岁，对照组平均年龄（33.29±8.53）岁。应用比色法检测两组研究对象血清HDL水平，应用循环酶法检测血清Hcy水平，应用重复性成套神经心理状态测验（RBANS）评估两组研究对象的认知功能水平，比较不同水平认知功能患者血清HDL、Hcy水平。应用Pearson 相关分析法分析患者血清HDL、Hcy水平与患者认知功能之间的关系。结果:与对照组相比，观察组的延时记忆、言语功能、即刻记忆、注意功能、视觉广度各因子评分均明显更低（均n P＜0.01），观察组BRANS总分明显低于对照组［（70.25±13.86）分比（84.29±12.94）分］（n t=6.06，n P＜0.01）。观察组中认知程度较好、一般、差患者的血清HDL水平分别为（1.26±0.31）mmol/L、（1.21±0.35）mmol/L、（1.18±0.29）mmol/L，均明显低于对照组的（1.46±0.55）mmol/L，差异均有统计学意义（均n P＜0.05），且患者双相障碍越严重血清HDL水平越低；观察组认知程度较好、一般、差患者的血清Hcy水平分别为（5.76±1.73）μmol/L、（6.12±1.87）μmol/L、（6.73±2.64）μmol/L，均明显高于对照组的（4.79±2.06）μmol/L，差异均有统计学意义（均n P＜0.05），且患者双相障碍越严重血清Hcy水平越高。经Pearson 相关性分析，患者的血清HDL水平与言语功能、RBANS总分均具有相关性（均n P＜0.01），患者的血清Hcy水平与延时记忆、言语功能、即刻记忆、注意功能、RBANS总分均具有相关性（均n P＜0.05）。n 结论:血清Hcy在双相障碍躁狂发作女性患者中呈高表达，且患者血清Hcy水平越高患者认知功能越差；血清HDL水平呈低表达，其水平较低会影响患者言语功能。“,”Objective:To investigate the relationship of the expressions of serum high-density lipoprotein (HDL) and homocysteine (Hcy) with cognitive function in female patients with bipolar disorder who have a manic episode.Methods:Sixty-seven female patients with bipolar disorder who had a manic episode and were treated at Zhanjiang Third People\'s Hospital from December 2019 to December 2020 were selected as an observation group, and 67 females who underwent physical examination at Zhanjiang Third People\'s Hospital during the same period were selected as a control group. The observation group were (33.76±8.42) years old. The control group were (33.29±8.53) years old. The serum HDL levels of the two groups were detected by the colorimetric method, and the Hcy levels by the enzymatic cycling assay. The Repetitive Neuropsychological State Test (RBANS) was used to evaluate the cognitive function levels of the two groups. The serum levels of HDL and Hcy of the patients with different levels of cognitive function were compared. The Pearson correlation analysis method was used to analyze the relationship between the serum HDL and Hcy levels and cognitive function in the patients.Results:The scores of delayed memory, speech function, immediate memory, attention function, and visual span in the observation group were obviously lower than those in the control group (all n P＜0.01); the total score of BRANS in the observation group was significantly lower than that in the control group [(70.25±13.86) vs. (84.29±12.94); n t=6.06, n P＜0.01]. The serum HDL levels of the patients with good, average, and poor cognition levels in the observation group were (1.26±0.31) mmol/L, (1.21±0.35) mmol/L, and (1.18±0.29) mmol/L, which were higher than that of the control group [(1.46±0.55) mmol/L], with statistical differences (alln P＜0.05). The serum Hcy levels of the patients with good, average, and poor cognition levels in the observation group were (5.76±1.73) μmol/L, (6.12±1.87) μmol/L, and (6.73±2.64) μmol/L, which were higher than that in the control group [(4.79±2.06) μmol/L], with statistical differences (all n P＜0.05); the more severe the bipolar disorder, the higher the serum Hcy level. According to the Pearson correlation analysis, the patients\' serum HDL level was correlated with their language function and RBANS total score (both n P＜0.05). The patients\' serum Hcy level was correlated with their delayed memory, speech function, immediate memory, attention function, and RBANS total score (all n P＜0.05).n Conclusions:Serum Hcy is highly expressed in female patients with bipolar disorder who have a manic episode; the higher the patients\' serum Hcy level, the worse the patients\' cognitive function; the expression of serum HDL level is low, and its low level will affect the patients\' speech function.