深静脉血栓病人血浆同型半胱氨酸水平探讨

目的 :研究血浆同型半胱氨酸 (Hcy)水平 ,探讨高同型半胱氨酸血症与深静脉血栓 (DVT )形成的关系。方法 :采用荧光偏振免疫法 (FPIA)测定 78例深静脉血栓病人和 95例健康对照者的血浆同型半胱氨酸 (Hcy)水平。结果 :空腹状态深静脉血栓组血浆同型半胱氨酸水平为 (13 .1± 7.6) μmol L ,明显高于对照组 (10 .6± 4.2 ) μmol L(P <0 .0 5)。蛋氨酸负荷试验后深静脉血栓组血浆同型半胱氨酸水平为 (41.6± 14 .8) μmol L ,显著高于对照组 (3 5.3± 13 .9) μmol L(P <0 .0 5)。轻中度升高的血浆同型半胱氨酸水平增加了深静脉血栓形成的危险性 (禁食后比数比OR =2 .995%CI 1.1～ 9.7;蛋氨酸负荷试验后比数比OR =3 .595%CI 1.3～ 10 .8)。结论 :血浆同型半胱氨酸水平与深静脉血栓形成密切相关 ,高同型半胱氨酸血症 (HHcy)是深静脉血栓形成的一个独立危险因子     

冠状动脉粥样硬化患者血浆同型半胱氨酸测定的临床意义

目的 :探讨血浆同型半胱氨酸水平测定在冠状动脉粥样硬化患者中的临床意义。方法 :应用荧光偏振免疫分析技术 ,测定 6 8例健康人和 85例冠状动脉粥样硬化患者血浆同型半胱氨酸 (Hcy)水平。结果 :血浆 Hcy水平正常对照组为 (9.31± 3.80 )μmol/L ,其中男性 (10 .5 0± 4 .0 7)μmol/L ,女性 (7.80± 2 .85 )μmol/L,男性明显高于女性 (P<0 .0 0 1) ;冠状动脉粥样硬化患者 (13.39± 6 .0 6 ) μmol/L,其中男性 (13.77± 6 .6 8) μmol/L,显著高于健康男性 (P<0 .0 0 1) ;女性 (11.5 0± 3.5 8) μmol/L,显著高于健康女性 (P<0 .0 0 1)。血浆 Hcy水平随冠脉病变严重程度呈上升趋势 ,冠脉不典型狭窄组 (11.36± 3.86 ) μmol/L,1支病变组 (13.32± 6 .0 9) μmol/L,2支病变组 (13.39±4 .92 ) μmol/L,3支病变组 (18.2 3± 8.98) μmol/L。结论 :冠状动脉粥样硬化患者存在高同型半胱氨酸血症 ,对于冠心病的诊断和治疗有重要价值。     

亚甲基四氢叶酸还原酶基因C677T多态性及高同型半胱氨酸血症与中国汉族人群肺血栓栓塞症的关联

为探讨亚甲基四氢叶酸还原酶 (MTHFR)C677T基因多态性与中国汉族人群肺血栓栓塞症 (PTE)的关联 ,观察高同型半胱氨酸血症 (HHc)是否为中国汉族人群肺血栓栓塞症的一个独立危险因素。采用聚合酶链反应 限制性片段长度多态性法检测 92例PTE患者 ,以及年龄、性别与PEG患者匹配的、来自同一区域的 92名对照者的MTH FRC677T基因多态性 ;采用酶联免疫吸附法 (ELISA)测定上述 92对入选对象的空腹血清同型半胱氨酸 (Hcy)浓度。结果 :①PTE组与对照组MTHFR基因C677T突变TT基因型的频率分别为 3 0 .4%和 2 9.4% ,2组T等位基因频率分别为 5 0 %和 47% ,差异均无显著意义 (P >0 .0 5 ) ;TT型与CC型比较发生PTE的相对危险度OR =1 .2 2 ,95 %CI为 0 .5 9～ 2 .5 1 ,表明TT基因型不增加PTE患病的危险性。②PTE组血清Hcy浓度为 ( 1 7.1± 9.3 9) μmol/L ,明显高于对照组 [( 1 3 .8± 7.4) μmol/L],P =0 .0 3 4;高同型半胱氨酸血症 (HHc)增加了PTE患病的危险性 (OR =3 .67,95 %CI为 1 .84～ 7.3 1 )③PTE组CC、CT、TT 3种基因型的Hcy浓度分别为 ( 1 4.8± 6.5 ) μmol/L、( 1 5 .8± 7.3 ) μmol/L、( 2 1 .5± 1 1 ) μmol/L ,对照组对应基因型的血清Hcy浓度分别为 ( 1 2 .1± 5 .2 ) μmol/L、( 1 1 .9± 7.0 ) μmol     

高同型半胱氨酸血症与脑梗死的相关性分析

目的:研究脑梗死患者血浆同型半胱氨酸水平的变化,证实高同型半胱氨酸血症是脑梗死的独立危险因素,及与脑卒中再发的关系。方法:对114例脑梗死患者作为病例组,取晨起空腹静脉血采用循环酶法测定两组血清同型半胱氨酸血症水平,并以同期40例健康体检者作为对照组,比较两组测定结果。结果:病例组血清高同型半胱氨酸血症水平为(22.0±10.2)μmol/L,高于对照组的((15.0±6.6)μmol/L(P<0.05);病例组中再发组患者血清高同型半胱氨酸血症水平为(21.5±5.5)μmol/L,高于首发组的(18.3±6.2)μmol/L(P<0.05)。结论:高同型半胱氨酸血症是脑梗死的独立危险因素,并且与缺血性脑卒中的再发关系密切。     

血浆同型半胱氨酸水平与老年脑卒中相关性研究

目的研究血浆同型半胱氨酸水平与老年脑卒中的关系。方法选取2013年1月~2015年12月收治的140例老年脑卒中患者,进行血浆同型半胱氨酸水平检测,对照组为60例老年健康体检者,比较两组血浆同型半胱氨酸水平。结果脑卒中组和对照组同型半胱氨酸水平分别为(15.79±4.73)μmol/L、(10.57±2.53)μmol/L,高同型半胱氨酸血症分别为93例(66.4%)、11例(18.3%),脑卒中人群血浆同型半胱氨酸水平与对照组比较差异显著(P0.01)。脑卒中组男女同型半胱氨酸水平分别为(18.85±3.51)μmol/L、(12.91±3.86)μmol/L,高同型半胱氨酸血症阳性率男女分别为62例(91.18%)、31例(43.06%),脑卒中组男女同型半胱氨酸水平比较差异显著(P0.01)。结论血浆高同型半胱氨酸水平是脑卒中的独立危险因素,对有脑卒中倾向的老年患者常规检测血浆同型半胱氨酸水平,控制高同型半胱氨酸血症,对预防脑卒中的发生有重要临床意义。     

脑梗死与脑出血患者血浆溶血磷脂酸含量的比较

目的 :探讨脑梗死与脑出血患者血浆溶血磷脂酸 (lysophosphatidicacid ,LPA)含量的变化规律 ,为临床诊断和治疗脑梗死提供依据。方法 :选择确诊的脑血栓形成、脑出血患者于发病 3天内、发病 2周时、发病 4周时取静脉血测定LPA含量 ,动态观察其变化过程。LPA检测采用有机溶剂提取 ,分离LPA ,用定磷法测定。结果 :脑血栓形成患者发病 3天内血浆LPA含量显著高于脑出血组及健康对照组 ,分别为 1 0 .6 3μmol/L± 3.6 7μmol/L ,2 .6 7μmol/L± 1 .4 0 μmol/L ,2 .0 4 μmol/L± 1 .0 1 μmol/L ;脑血栓形成组LPA的增高可持续 2周 (发病 2周时含量为5 .31 μmol/L± 1 .94 μmol/L) ,发病第 4周时降至正常水平 (2 .0 9μmol/L± 1 .0 1 μmol/L) ,总体规律为发病时明显增高 ,而后呈逐渐下降趋势。脑出血组发病 2周时含量 2 .5 4 μmol/L± .91 μmol/L、发病四周时含量 2 .2 8μmol/L±1 .0 4 μmol/L,与出血发病 3天内含量及对照组比较无显著性差异。结论 :LPA可以作为鉴别脑梗死与脑出血的一个指标 ,用来指导脑梗死的治疗     

无症状性脑梗死患者血浆同型半胱氨酸的测定及其临床意义

目的研究血浆同型半胱氨酸水平与无症状性脑梗死的关系。方法运用高效液相色谱法测定60例门诊和住院的无症状性脑梗死患者及60例健康体检者血浆总同型半胱氨酸（tHcy）水平。结果无症状性脑梗死患者血浆总Hcy水平（14．25&#177;4．30）μmol／L,明显高于健康对照组（9．21&#177;3．24）μmol／L,具有显著性差异（P〈0．01）。结论高Hcy血症可能是无症状性脑梗死危险因素之一。     

血浆同型半胱氨酸水平与急性心肌梗死的关系

目的　探讨血浆同型半胱氨酸 (Hcy)水平与急性心肌梗死 (AMI)之间的关系。方法　应用高效液相色谱仪测定血浆Hcy水平 ,对 50例确诊急性心肌梗死患者与 50例正常对照者进行比较分析。结果　AMI组和对照组血浆Hcy水平分别为 (1 6 73± 4 0 1 ) μmol/L和 (1 0 87± 2 95) μmol/L ,两者差异有显著性 (P <0 0 5)。在 37例行冠状动脉造影的AMI患者中 ,多支病变组 (≥ 2支血管病变 )的血浆Hcy水平显著高于单支病变组 [(1 7 2 5± 4 .86) μmol/Lvs (1 2 .2 3±5 1 7) μmol/L ,P <0 0 5]。 结论　高Hcy血症可能是AMI的一种独立危险因素 ,且冠脉病变越严重 ,血浆Hcy水平越高。     

慢性肾功能不全患者血浆同型半胱氨酸水平测定及其临床意义

对年龄、性别配对的慢性肾功能不全患者和正常对照组各 42例 ,运用高效液相色谱仪和荧光检测仪测定其血浆总同型半胱氨酸 (tHcy)水平。结果 ,慢性肾功能不全组血浆tHcy水平 (4 9.0 9± 44 .81μmol/L)显著高于正常对照组 (10 .86± 3.0 7μmol/L ,P <0 .0 0 1)。结果表明 ,血浆同型半胱氨酸水平的测定对慢性肾功能不全的诊断与指导治疗具有重要的临床意义。     

缺血性脑卒中患者血浆溶血磷脂酸水平的初步研究

目的　探讨短暂性脑供血不全发作 (TIA)和脑血栓形成以及疑似脑供血不全发作患者血浆溶血磷脂酸水平的变化。方法　采用有机溶剂抽提 ,并进一步分离出溶血磷脂酸 ,以定磷方法测定。结果　TIA和脑血栓形成以及疑似脑供血不全发作患者血浆溶血磷脂酸水平均显著高于对照组 (1 0 0 μmol/L± 0 70 μmol/L) ,分别为 2 14 μmol/L± 1 0 2 μmol/L、1 5 0 μmol/L± 0 85 μmol/L、1 73μmol/L± 1 14 μmol/L血浆 (P <0 0 5 )。经抗血小板聚集药物或抗凝血药物治疗患者血浆溶血磷脂酸水平下降。结论　作为体内凝血和血栓形成过程早期释放的分子标记物 ,血浆溶血磷脂酸可能在缺血性脑卒中诊断方面有重要应用前景     

高同型半胱氨酸血症与深静脉血栓形成

目的研究亚甲基四氢叶酸还原酶(MTHFR)C677T位点基因多态性及血清叶酸、维生素B12(VitB12)与血浆同型半胱氨酸(Hcy)水平和深静脉血栓形成DVT的关系。方法采用聚合酶链反应-限制性片段长度多态性法(PCR-RFLP)检测111例对照者和69例DVT患者的MTHFRC677T基因型,放射免疫法(RIA)测定血清叶酸和VitB12浓度,荧光偏振免疫法(FPIA)测定血浆Hcy水平。结果DVT组与对照组MTHFRC677T的TT基因型频率和T等位基因频率均无显著性差异;DVT组的血浆Hcy水平为(13.03±8.74)μmol/L,明显高于对照组的(10.14±4.30)μmol/L(P<0.05),两组叶酸和VitB12的差异均无显著性;高同型半胱氨酸血症增加了DVT患病的危险性(OR=2.53,95%CI1.08～5.92)。低叶酸水平和TT基因型共同作用增加DVT危险性(OR=3.1295%CI1.17～8.38)。结论高同型半胱氨酸血症是汉族人DVT发病的独立危险因素;血清叶酸水平、MTHFRC677T位点基因多态性均不是DVT的独立危险因素,但两者间存在的交互作用可共同影响血浆Hcy水平。     

The prevalence of MTHFR 677C-->T missense mutation, total plasma homocysteine levels and associated risk factors in Malay subjects

The missense mutation of the methylenetetrahydrofolate reductase (MTHFR) gene 677C-->T is associated with modest elevation of homocysteine levels. The bio-ecogenetics factors of total homocysteine levels (tHcy) were investigated in a cross sectional study involving 53 randomly selected healthy Malay subjects. Results indicated that the prevalence of the homozygous 677T/T was 3.8% and heterozygous 677C/T was 17.0%. The levels of tHcy was higher in subjects aged more than 50 years (n = 7, 11.53 +/- 4.45 mumol/l) and in males (10.99 +/- 3.77 mumol/l) especially smoking males (12.19 +/- 3.62 mumol/l). THcy levels were low in the 3 pregnant subjects (4.44 mumol/l, p = 0.036) who were under folate supplementation.     

ASSOCIATION OF PLASMA HOMOCYSTEINE LEVEL AND N^5,N^10—METHYLENETETRAHYDROFOLATE REDUCTASE GENE POLYMORPHISM WITH CEREBRAL INFARCTION

OBJECTIVE: To investigate the relationship of plasma homocysteine (Hcy) level to stroke and genetic factor to elevated plasma Hcy level. METHODS: The plasma Hcy level was measured by capillary electrophoresis-ultraviolet detection and the gene polymorphism of N5,N10-methylenetetrahydrofolate reductase (MTHFR) was studied with PCR-RFLP assay in 43 patients with cortical cerebral infarction and 42 healthy control. RESULTS: The plasma Hcy level of the patients (19.3 +/- 6.0 micromol/L) was markedly higher than that of the controls (13.7 +/- 5.4 micromol/L) (t = 4.16, P < 0.001). There are 3 genotypes, C/C, C/T and T/T, about base-variation of MTHFR gene at locus 677. The plasma Hcy level of the subjects with T/T genotype was higher than that of subjects with other genotypes. However, the frequencies of each genotype and allele were not significantly different between the patients and the controls. CONCLUSIONS: The elevated plasma Hcy level is a risk factor for atherothrombotic cerebral infarction, and is related to the C-->T mutation at locus 677 of MTHFR gene.     

慢性血液透析患者透析前后血浆同型半胱氨酸的变化

OBJECTIVE: To determine the plasma hemocysteine (Hcy) concentration in chronic hemodialysis patients and controls, and the relation between chronic hemodialysis and the plasma total Hcy level in chronic hemodialysis patients. METHODS: Using HPLC-FLD method, the plasma total Hcy concentration was determined in 11 patients with chronic hemodialysis and 30 healthy volunteers. RESULTS: The plasma total Hcy level in chronic hemodialysis was significantly higher than that in the controls (13.54 +/- 4.49 mumol/L) (P < 0.01). The plasma total Hcy level after the hemodialysis (21.30 +/- 10.81 mumol/L) was lower than before the hemodialysis (29.53 +/- 13.59 mumol/L) (P < 0.01). CONCLUSION: The plasma total Hcy level in chronic hemodialysis patients was higher than that in the controls. Hemodialysis can clean the plasma Hcy in chronic hemodialysis patients, but it can not decrease it to the normal level.     

冠心病患者血浆同型光胱氨酸的变化及其机制的探讨

OBJECTIVE: To identify hyperhomocysteinemia (HHe) as a new and independent risk factor for coronary heart disease (CHD). METHODS: The association of coronary heart disease (CHD) and lipid, homocysteine (HCY) and the factors related to its metabolisms were examined. The mutation of the 677C-->T transition of MTHFR was determined by PCR-based assay. Whole blood and plasma folate (FA) and plasma vitamin B12(B12), as cofactors of those enzymes, were determined by radioimmunologic assay. Plasma HCY was determined by HPLC. RESULTS: Patients with CHD confirmed by coronary angiography had increased plasma HCY concentrations (17.1 +/- 3.6 mumol/L, 7.6 +/- 1.2 mumol/L). In patients with MI, HPT and family history (FH) of CHD, plasma HCY increased significantly. Plasma HCY concentrations had significant non-linear inverse relation with plasma FA and B12 concentrations. Homozygous mutants showed higher plasma HCY concentrations. Patients with CHD had increased serum CHOL and VLDL levels, but plasma HCY concentrations were not correlated with serum lipid levels. CONCLUSION: Hyperhomocysteinemia is an independent risk factor for coronary heart disease.     

血浆同型半胱氨酸水平与糖尿病肾病关系的探讨

目的:探讨血浆总同型半胱氨酸(total homocysteine,tHcy)水平变化与2型糖尿病肾病的关系。方法:检测60例2型糖尿病患者(其中糖尿病肾病组30例,单纯糖尿病组30例)及30例正常对照组的血浆tHcy、空腹血糖、空腹胰岛素,进行比较分析。结果:糖尿病肾病组血浆tHcy显著高于单纯糖尿病组及正常对照组(P<0.05)。结论:2型糖尿病肾病患者存在高同型半胱氨酸血症,同型半胱氨酸在2型糖尿病肾病的发生发展中起重要作用。     

高同型半胱氨酸血症与青年脑梗死关系的研究

目的研究青年脑梗死患者空腹及蛋氨酸负荷后血浆总同型半胱氨酸(tHcy)水平,及其与纤维蛋白溶解系统之间的相互作用。方法观察组(80例)均为我院1999年1月—2003年5月首次发病住院脑梗死患者,年龄18~44岁,于发病后3d、30d分别测定空腹和蛋氨酸负荷后tHcy水平及纤维蛋白溶解系统功能;对照组为同龄健康者50例,同样进行上述检查。结果观察组与对照组比较,空腹及蛋氨酸负荷后tHcy水平在发病后3d和30d差异无统计学意义(P均>0.05),而蛋氨酸负荷后tHcy升值水平(负荷后tHcy水平减去空腹tHcy水平)在发病后3d和30d差异均有统计学意义(P均<0.05);蛋氨酸负荷后tHcy升值水平增高使脑梗死风险性增加4.8倍;蛋氨酸负荷试验反应异常与组织型纤溶酶原激活剂(t-PA)浓度增高,纤溶酶原激活物抑制剂-I(PAI-I)活性升高及t-PA活性降低有关。结论蛋氨酸负荷后tHcy升值水平中度增高使青年脑梗死患病风险性增加,这可能是一个新的促进血栓形成的危险因素,该作用部分由其与纤溶系统的相互作用介导;青年脑梗死患者的空腹tHcy水平正常并不等于同型半胱氨酸代谢正常,诊断高同型半胱氨酸血症需要进行蛋氨酸负荷试验。     

脑白质疏松症患者情感淡漠与同型半胱氨酸水平的关系

目的 研究脑白质疏松症（LA）患者情感淡漠发生率与同型半胱氨酸（tHcy）之间的关系。 方法 选取西南医科大学附属医院神经内科LA 患者和头颅影像无明显异常者作为LA 组和对照组,应用修订 版情感淡漠评定量表评估两组间情感淡漠发生率,并比较各组间tHcy 差异。结果 LA 组情感淡漠发生率高 于对照组（P <0.05）,LA 组tHcy 水平较对照组高（P <0.05）,中、重度LA 患者tHcy 水平高于轻度者（P <0.05）, 通过比较伴与不伴情感淡漠的LA 患者发现,前者血清tHcy 高于后者（P <0.05）。结论 LA 患者有着较高的 情感淡漠发生率,且tHcy 水平与LA 发生有着密切关系。LA 患者伴情感淡漠比不伴有更高的血清tHcy 水平。 tHcy 可能同时在LA 及情感淡漠的发生中发挥重要作用。     

RELATIONSHIP OF HOMOCYSTEINE AND GENE POLYMORPHISMS OF ITS RELATED METABOLIC ENZYMES WITH ALZHEIMER＇S DISEASE

OBJECTIVE: To investigate the relationship of plasma homocysteine (Hcy) levels and the gene polymorphisms of N5, N10-methylenetetrahydrofolate reductase (MTHFR), cystathionine beta-synthase (CBS) with Alzheimer's disease (AD). METHODS: Plasma Hcy levels were measured by means of high voltage capillary electrophoresis with ultra-violet detection, the polymorphisms of C677T in exon 4 of MTHFR gene and 844ins68 in exon 8 of CBS gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 105 AD patients and 102 non-AD controls. All controls were excluded from cardiocerebrovascular disorders and other diseases. RESULTS: The plasma Hcy level in AD patients (16.04 +/- 3.84 micromol/L) was significantly higher than that in the controls (11.94 +/- 3.87 micromol/L, P < 0.001). There were no significant differences of the genotype and allele frequencies of MTHFR C677T mutation and CBS 844ins68 mutation between the patients and controls. However, the T allele of MTHFR gene was found to relate with the plasma Hcy level increase in all subjects. CONCLUSION: The elevated plasma Hcy level in AD patients is probably involved in the pathogenesis of AD, which may be due to the environmental factor rather than genetic factors of the mutations of MTHFR and CBS.     

凝血酶原G20210基因多态性与中国汉族人群肺血栓栓塞症的相关性

目的探讨凝血酶原基因3’端非翻译区20210 G/A多态性与中国汉族人群肺血栓栓塞症(PTE)发生的相关性。方法采用病例-对照研究,病例组为经放射性核素肺通气/灌注显像和(或)螺旋CT肺动脉造影(CTPA)检查,并结合临床资料确诊的PTE患者101例;对照组为与PTE患者来自相同地区,性别、年龄相匹配的健康对照101例。应用碘化钾-氯仿-异丙醇法提取基因组。应用聚合酶链反应(PCR)、HindⅢ限制性内切酶片段长度多态性分析(RFLP)及聚丙烯酰胺凝胶电泳(PAGE)等方法检测凝血酶原G20210多态性。结果健康对照人群GⅡ20210A位点的基因频率符合Hardy-Weinberg平衡定律,PTE病例组及对照组GⅡ20210A位点均为野生型(GG)纯合子,GA、AA基因型频率为0,A等位基因频率为0。结论凝血酶原G20210A基因多态性与中国汉族人群PTE发生可能无关。