冠心病患者血浆中新型气体信号分子硫化氢的变化

OBJECTIVE: To investigate the changes of plasma hydrogen sulfide (H(2)S) in patients with coronary heart disease (CHD). METHODS: Plasma H(2)S levels were measured in 40 patients with CHD and 17 angiographically normal patients by sulfide-sensitive electrodes, and the variation of plasma H(2)S levels was analyzed in different clinical types of CHD and in different types of coronary artery lesions. The association of plasma H(2)S levels with the risk factors of CHD was also analyzed. RESULTS: Plasma H(2)S levels were significantly lowered in CHD patients in comparison with that in angiographically normal control subjects (26.10+/-14.27 micromol/L vs 51.74+/-11.94 micromol/L, P<0.001). In CHD patients, plasma H(2)S levels in unstable angina patients (UAP, 23.60+/-14.41 micromol/L) and acute myocardial infarction patients (AMI, 19.98+/-7.516 micromol/L) were significantly lower than that in stable angina patients (SAP, 38.41+/-14.53 micromol/L, P<0.05). No significant difference in plasma H(2)S levels was found between CHD patients with double-vessel and multi-vessel lesions (16.91+/-7.98 vs 18.39+/-7.78 micromol/L, P>0.05), but the two groups of patients had significantly lower plasma H(2)S levels than patients with single-vessel involvement (33.04+/-15.01 micromol/L, P<0.05 and P<0.01, respectively). Plasma H(2)S level was significantly lower in CHD patients with coronary artery occlusion than in patients with simple stenosis (19.04+/-9.55 vs 28.24+/-14.85 micromol/L, P<0.05). Among the CHD patients, H(2)S levels were significantly lower in smokers than in non-smokers (27.54+/-10.37 vs 32.24+/-15.77 micromol/L, P<0.05), also lower in hypertensive patients than in normotensive patients (20.36+/-8.69 vs 33.77+/-15.86 micromol/L, P<0.01). Plasma H(2)S levels showed a significant inverse correlation with blood glucose (r=-0.493 6, P=0.001 6), but there were no significant correlations with sex, age, cholesterol, triglyeride, TC, low-density lipoprotein, high-density lipoprotein, or body mass index. CONCLUSION: Decreased plasma H(2)S levels may correlate with the severity of CHD and changes of the coronary artery, and may implicate the risk factors of CHD such as smoking, hypertension, and high blood glucose.     

血浆同型半胱氨酸及胱硫醚β合成酶多态性与脑血栓形成

目的探讨血浆同型半胱氨酸(Hcy)及胱硫醚β合成酶(CBS)基因多态性与脑血栓形成的关系.方法应用高效液相色谱-荧光法及扩增阻滞突变体系法测定87例急性脑血栓形成患者和80例对照者血浆Hcv浓度和CBS基因型.结果病例组平均空腹血浆Hcy浓度15.28 μmol/L(95%CI为14.37～16.19)较对照组11.32μmol/L(95%CI?0.47～12.16)高(P＜0.001).CBS两突变位点对血浆Hcy浓度的影响不一致.病例组和对照组基因型分布、纯合子频率和等位基因频率差异均无统计学意义.结论高Hcy血症与脑血栓形成发病有关.     

儿童青少年血浆新型气体信号分子硫化氢的参考值

目的 测定儿童与青少年血浆硫化氢含量的参考值.方法 健康儿童青少年200名,按照其年龄与性别分组,7～14岁75名(男43名,女32名),15～19岁125名(男64名,女61名),应用敏感硫电极法测定血浆硫化氢(H2S)含量.结果 学龄期7～14岁男孩血浆H2S含量为(52.2181±17.9400)μmol/L,女孩H2S含量为(51.9441±16.5448)μmol/L;15～19岁男孩血浆H2 S含量为(52.8771±14.1444)μmol/L,女孩H2 S含量为(53.6551±14.5563)μmol/L.各年龄组间及性别间差异均无显著性(P＞0.05),合并统计后得出儿童青少年血浆H2S含量的浓度均值为(52.8234±15.4339)μmol/L.结论 儿童青少年血浆H2S含量参考值为(52.8234±15.4339)μmol/L.     

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.     

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.     

血浆不对称二甲基精氨酸水平与冠状动脉硬化关系的研究

目的研究不对称二甲基精氨酸（ADMA）水平是否与冠状动脉粥样硬化的病变范围和严重程度有关。方法110例行冠状动脉造影术的患者根据造影结果分为冠状动脉造影正常的对照组22例,轻度动脉硬化组21例,造影显示冠状动脉内膜不光滑,但无明显的狭窄或狭窄小于50％;单支病变组22例,造影显示1支主要的冠状动脉分支出现明显狭窄（≥50％）;双支病变组22例,两支主要的冠状动脉分支出现明显狭窄;多支病变组23例,两支以上主要的冠状动脉分支出现明显狭窄或伴有左主干病变。血浆ADMA水平的检测采用酶联免疫法。结果除轻度动脉硬化组ADMA水平（1．21μmol／L±0．36μmol／L,P=0．288）偏低外,单支病变组、双支病变组和多支病变组患者的ADMA水平均高于对照组（1．52μmol／L±0．61μmol／L,1．67μmol／L±0．80μmol／L和2．60μmol／L±0．62μmol／L vs 0．79μmol／L±0．54μmol／L,P〈0．01）。经过多元相关与Logstic等级回归分析,ADMA水平与冠状动脉病变程度密切相关。结论血浆ADMA水平升高可以预测冠状动脉粥样硬化的发生,ADMA可能是一种新的冠心病危险因子。     

血浆同型半胱氨酸与青年脑梗死的关系研究

目的探讨血浆同型半胱氨酸与青年脑梗死的关系。方法回顾性分析2010年1月-2011年1月神经内科收治的60例青年脑梗死患者的血浆同型半胱氨酸水平,对照组为60例青年健康体检者,比较两者血浆同型半胱氨酸水平。结果青年脑梗死患者的血浆同型半胱氨酸水平高于正常对照组。脑梗塞组和健康体检组同型半胱氨酸水平分别为(23.45±5.52)μmol/L、(11.75±4.74)μmol/L,高同型半胱氨酸血症分别为43例(71.6%)、11例(18.3%)。脑梗死组男性患者血浆同型半胱氨酸阳性率高于女性。男性32例,女性11例,血浆同型半胱氨酸阳性率分别为92.4%、44.0%。结论高同型半胱氨酸血症是青年脑梗死独立的重要危险因子。对有脑血管病倾向的青年患者可常规检查同型半胱氨酸水平。高同型半胱氨酸血症早期发现,早期干预,对预防和治疗脑梗塞有重要意义。     

Homocysteinemia in hypertensive patients with renal target organ damage (mild renal dysfunction)

The prevalence of high plasmatic levels of homocysteine in hypertensive patients with mild renal dysfunction (MRD) defined by 2003 European Hypertension Society Guidelines (men plasmatic creatinine between 1.3 and 1.5; women plasmatic creatinine between 1.2 and 1.4 mg/dl) has not been previously reported. To evaluate this item 18 MRD patients were recruited (54% males, mean age 59.2 +/- 17.3 years, mean plasmatic creatinine 1.30 +/- 0.12 mg/dl). They were compared with a control group of hypertensives with normal renal function (n = 87, 42,9% males, mean age 53.6 +/- 12.3 years, mean plasmatic creatinine 0.83 +/- 0.21 mg/dl) and a group of 29 chronic renal failure patients (51.7% males, mean age 56.9 +/- 15.0 years, mean plasmatic creatinine 2.39 +/- 0.95 mg/dl). Age and sex differences are not significant, plasmatic creatinine levels are different among three groups (p <0.001, t student test). Basal homocysteine levels of CRF (19.3 +/- 7.1 micromol/l) were higher than those of control group (11,0 +/- 4,3 micromol/l) and MRD patients (14.8 +/- 5.5 micromol/l; p = 0.027 vs. CRF and p = 0.007 vs. control, Mann-Whitney test). Mean creatinine clearance was 30.3 +/- 11.5 ml/min for CRF group, significantly lower than MRD patients creatinine clearance (54.5 +/- 9.4 ml/min, p <0.001, t student test) and control ones (88,9 +/- 18,9 ml/min, p <0.001, t student test). Hypertensive patients with mild renal dysfunction showed higher and pathological levels of homocysteinemia as compared with controls, this finding might be related to the higher cardiovascular risk described in this group of patients.     

HSP-27在冠心病中表达的临床研究

目的:探讨热休克蛋白-27(HSP-27)在冠心病患者中的临床应用价值及指导意义。方法:将63例冠状动脉造影患者分为三组:急性心肌梗死(AMI)组,不稳定心绞痛(UAP)组,胸痛综合征组。上述患者均经冠脉造影、临床表现、心电图、心肌酶学检查诊断明确。采用Elisa分析方法测定上述3组患者血浆HSP-27的浓度,比较分析患者血浆HSP-27水平。结果:HSP-27血浆水平在AMI组>UA组>胸痛综合征,且具有统计学意义,P<0.05。结论:HSP-27血浆浓度在不同类型动脉粥样硬化性心脏病中有差异性,且随着冠心病程度加重血浆浓度增加,HSP-27可作为心肌缺血诊断指标。     

冠心病患者平板运动试验Duke评分与冠状动脉造影校正的TIMI帧数的相关性研究

目的:探讨冠心病患者平板运动试验Duke评分(Duke treadmill score,DTS)与冠状动脉造影评价预后的指标--校正的TIMI帧数(corrected thrombolysis in myocardial infarction frame count,CTFC)之间的相关性,为无创平板运动试验评价冠心病患者的预后提供依据.方法:对冠状动脉造影确诊为冠心病,并在造影前2周内完成平板运动试验的72例患者进行分析.根据平板运动试验和冠状动脉造影结果分别计算Duke评分和CTFC,并根据Duke评分进行分组﹙≥5分为低危组、＜5分为中高危组);分析Duke评分与CTFC的相关性,比较不同危险分层各组之间CTFC的差异.结果:平板运动试验Duke评分与冠状动脉前降支、回旋支、右冠状动脉的CTFC均呈负相关(r=-0.821、-0.730、-0.598,P＜0.001).Duke评分低危组三支冠状动脉的CTFC值明显小于中高危组[前降支:分别为(22.27±3.71)帧、(24.12±4.19)帧;回旋支:分别为(27.96±5.65)帧、(31.28±6.79)帧;右冠状动脉:分别为(21.96±5.85)帧、(24.64±7.33)帧],组间CTFC值有明显差异(P＜0.05).结论:冠心病患者平板运动试验Duke评分与冠状动脉前降支、回旋支、右冠状动脉的CTFC值呈负相关.根据Duke评分得出的危险分层与CTFC有良好的相关性,此结果可能为平板运动试验Duke评分这种无创手段用于评价冠心病患者预后提供理论依据.     

老年缺血性心肌病患者血尿酸水平变化分析

目的 探讨老年缺血性心肌病(ICM)患者血尿酸水平变化的临床意义. 方法 收集冠状动脉造影证实为冠心病心绞痛及无症状心肌缺血≥60岁的患者235例,其中超声心动图检测左心室舒张末直径(LVDd)男性>55 mm,女性>50 mm共154例作为ICM组,LVDd平均为(64±8)mm;而LVDd男性≤55 mm,女性≤50 mm共81例作为非ICM组,LVDd平均为(46±5)mm.分析ICM组与非ICM组间血尿酸水平差异. 结果 ICM组血尿酸水平[(433±143)μmol/L]较非ICM组[(361±137)μmol/L]显著增高,差异有统计学意义(P<0.05).血尿酸水平与LVDd显著正相关(r=0.25,P<0.05). 结论 老年冠心病并发ICM患者血尿酸水平显著增高,且血尿酸水平与LVDd显著正相关.     

Elevation of procalcitonin level in patients with pulmonary tuberculosis and in medical staff with close patient contact

BACKGROUND: Several studies have shown that serum procalcitonin levels increase conspicuously in acute and systemic inflammatory diseases. However, there is insufficient information concerning its activity in chronic infectious diseases such as tuberculosis. In this study, we aimed to assess serum level of procalcitonin in patients with active pulmonary tuberculosis and in medical staff at high risk due to close patient contact (high-risk staff). METHODS: For this purpose, 30 patients (6 female, 24 male) and 20 staff (8 female, 12 male) were evaluated. Twenty eight healthy blood donors (9 female, 19 male) made up the control group. RESULTS: Serum procalcitonin level in patients with tuberculosis was 0.76 +/- 0.20 ng/mL. Procalcitonin levels in active tuberculosis patients and staff were not significantly different (p=0.381); however, differences between active tuberculosis patients and control group were significant (p<0.001). In addition, serum procalcitonin levels were also different in staff and control groups (p<0.001). CONCLUSIONS: This study showed that procalcitonin levels increased both in patients with pulmonary tuberculosis and in the staff. This result considered that procalcitonin could be a good indicator of inflammation in patients with chronic diseases and in persons exposed to long-lasting infections.     

肝硬化患者血浆抗坏血酸和维生素E的测定

目的 :探讨肝硬化患者血浆抗坏血酸和维生素 E的水平及其意义。方法 :测定 6 3例肝硬化患者和 6 3例年龄及性别配对的正常人血浆抗坏血酸 ,维生素 E和过氧化脂质的含量。结果 :肝硬化组血浆抗坏血酸含量为( 42 .94± 6 .99)μm ol/ L ,明显低于对照组 ( 53.30± 9.4 5)μm ol/ L ( t=9.50 ,P =0 .0 0 0 ) ;肝硬化组血浆维生素 E含量为 ( 17.99± 3.51) μm ol/ L,明显低于对照组 ( 2 4 .59± 7.2 2 ) μm ol/ L( t=7.94 ,P=0 .0 0 0 ) ;肝硬化组血浆过氧化脂质含量为 ( 14 .0 9± 1.2 8) μm ol/ L,明显高于对照组 ( 12 .11± 1.2 0 ) μmol/ L( t=17.2 1,P=0 .0 0 0 )。而且肝硬化患者的三个指标之间均有良好的相关性 ( P=0 .0 0 0 )。结论 :肝硬化患者血浆抗坏血酸和维生素 E水平显著下降 ,体内氧化和抗氧化系统失衡。     

急性脑梗死患者血浆同型半胱氨酸测定的意义

目的观察急性脑梗死患者血浆同型半胱氨酸（Hcy）水平,探讨Hcy测定在急性脑梗死诊断、疗效观察以及早期预防中的作用。方法采用酶循环法测定76例急性脑梗死患者治疗前后和60例体检正常的健康者（对照组）血浆Hcy浓度。结果急性脑梗死组血浆Hcy含量明显高于对照组（P〈0.001）,差异有统计学意义。且急性脑梗死患者治疗后的血浆Hcy含量显著下降（P〈0.001）,差异有统计学意义。结论高同型半胱氨酸血症与急性脑梗死的发生有关,血浆同型半胱氨酸水平可以作为急性脑梗死的诊断和疗效观察的辅助指标。     

低剂量叶酸对高同型半胱氨酸血症患者血浆同型半胱氨酸及趋化因子水平的影响

目的观察低剂量叶酸治疗对高同型半胱氨酸血症(HHcy)患者血浆同型半胱氨酸及趋化因子水平的影响。方法给予40名HHcy患者叶酸0.8mg/d治疗6个月,在治疗前、后分别采集空腹静脉血,检测血浆Hcy、叶酸、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-8(IL-8)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果叶酸治疗6个月后,HHcy患者的血浆Hcy水平为(25.8±12.0)μmol/L,明显低于治疗前的(57.1±18.0)μmol/L(P<0.05)。患者的MCP-1、IL-8、SOD和MDA水平则在治疗前、后差异均无显著性。结论低剂量叶酸治疗可降低HHcy患者的Hcy水平,但对趋化因子的水平无影响。     

肢体与心肌缺血后处理对兔急性心肌缺血再灌注损伤的对比研究

目的探讨在体状态下,肢体缺血后处理是否具有减轻心肌缺血再灌注损伤的作用,并探讨其机制。方法在新西兰大白兔心肌缺血再灌注模型,给予冠状动脉左前降支(LAD)30 m in缺血,180 m in再灌注。所有动物随机分为4组(每组10只):(1)对照组;(2)心肌缺血预处理组;(3)心肌缺血后处理组;(4)肢体缺血后处理组;在缺血前、后及再灌注结束后分别测定血浆磷酸肌酸激酶(CK)和丙二醛(MDA)活性;实验结束后,测定心肌梗死面积并检测心肌组织髓过氧化物酶(MPO)活性。结果心肌缺血预处理组、心肌缺血后处理组和肢体缺血后处理组心肌梗死面积分别为15.5%±1.7%、16.2%±2.0%、17.1%±1.7%,均明显低于对照组(31.5%±1.3%,P<0.01);再灌注3h末血浆CK活性,肢体缺血后处理组与对照组分别为18.0 IU/g±1.6 IU/g与45.6 IU/g±5.5IU/g(P<0.01);缺血预处理组、缺血后处理组和肢体缺血后处理组在再灌注3h末MDA活性分别为2.12μmol/m l±0.30μmol/m l、2.17μmol/m l±0.24μmol/m l和2.16μmol/m l±0.33μmol/m l,均明显低于对照组(3.49μmol/m l±0.32μmol/m l(P<0.01);心肌缺血预处理组、心肌缺血后处理组和肢体缺血后处理组中性粒细胞在缺血心肌的聚集程度,即组织MPO活性分别为1.43 U/100 g±0.32U/100 g、2.26 U/100 g±0.28 U/100 g和2.45 U/100 g±0.28 U/100 g,均较对照组(5.44 U/100 g±0.46 U/100 g)明显降低(P<0.01)。结论对于已经缺血的心肌,在再灌注前给予肢体短暂缺血再灌注处理具有与心肌缺血预处理相似的心肌保护作用。这种远隔器官缺血后处理心肌保护作用可能与减轻活性氧的损伤及抗氧化作用加强有关。     

高血压患者凝血、纤溶活性变化及硝苯地平缓释剂对它的影响

OBJECTIVE: To investigate the changes of coagulation and fibrinolysis status in patients with essential hypertension (EH) and observe the therapeutic effect of sustained-release nifedipine. METHODS: Ninety-nine EH patients were divided according to their diastolic blood pressure (DBP) into mild group (48 cases), moderate group (29 cases) and severe group (22 cases), and 25 patients among the groups were chosen at random to receive sustained-release nifedipine for 2 weeks. Twenty healthy subjects served as control group. Plasma D-dimer (DD), fibrin monomer (FM) and tissue-type plasminogen activator (tPA) levels were determined in all the subjects by enzyme-linked immunosorbent assay (ELISA). RESULTS: The plasma DD and FM levels were much higher, while tPA level was much lower in hypertensives than those of normal controls, exacerbating with the severity of the disease. DBP was positively correlated with plasma FM level (r=0.374,P<0.001). In patients with left ventricular hypertrophy, left ventricular enlargement and left atrial enlargement, higher levels of DD, FM and tPA were detected. Nifedipine treatment produced significant reduction in plasma DD and FM levels along with the increase in tPA level [DD: (40.7+/-23.5) mg/dl vs (23.8+/-16.5) mg/dl; FM: (7.0+/-1.6) ng/microliter vs (4.8+/-1.5) ng/microliter tPA: (0.31+/-0.14) ng/ml vs(0.41+/-0.05) ng/ml, P<0.001]. CONCLUSION: Enhanced coagulative activity and lowered fibrinolytic activity characterize EH patients and nifedipine may correct this disorder.     

上海农村社区老年人高同型半胱氨酸血症患病率及其相关因素

 目的   研究上海市农村社区老年人群高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)的患病率和分布特征,并分析其主要相关因素。方法   以上海市浦东新区大团社区≥60岁老年人群为研究对象,通过横断面调查检测其血浆同型半胱氨酸(homocysteine,Hcy)水平及分布特征,并采用多因素非条件Logistic回归分析影响Hcy水平的高危因素。结果   在1 621例≥60岁的老年人群中,男性血浆Hcy平均水平高于女性［(15.72±9.22) μmol/L vs.(14.08±7.55) μmol/L,P<0.001］,男性HHcy患病率高于女性(43.6% vs.29.5%,P<0.001)。<70岁、70~80岁、>80岁的老年人血浆Hcy值分别为(13.75±5.43)、(15.26±9.72)和(15.55±9.12) μmol/L(P=0.001);HHcy患病率分别为23.9%、40.5%和46.3%(P<0.001)。吸烟组和不吸烟组Hcy水平分别为(16.14±8.05)和(14.60±8.31) μmol/L(P=0.037),HHcy患病率分别为44.9%和34.2%(P=0.011)。高血压组和无高血压组Hcy水平分别为(15.24±9.72)和(14.20±6.42) μmol/L(P=0.012),HHcy患病率分别为39.7%和30.3%(P<0.001)。多因素Logistic回归分析表明,性别、年龄和高血压是HHcy的危险因素,优势比(odds ratio,OR)分别为1.92(95%CI为1.46～2.54,P<0.001)、1.89(95%CI为1.55～2.29,P<0.001)和1.57(95%CI为1.20～2.05,P=0.001)。结论   上海大团社区老年人群中Hcy血浆水平存在性别、年龄差异,HHcy的危险因素包括性别、年龄和高血压。       

伴有阻塞性睡眠呼吸暂停低通气综合征的脑梗死患者血同型半胱氨酸的变化

目的 探讨脑梗死伴随阻塞性睡眠呼吸暂停低通气综合征(OSA)患者的血同型半胱氨酸(Hcy)的水平变化.方法 从南京卒中注册系统中筛选2009年3-12月男性急性脑梗死患者,共92例,根据呼吸暂停加低通气指数(AHI)值将病例为无OSA组(AHI＜5/h)与伴OSA组(AHI≥5/h)两组,在脑梗死发病后第(14±2)天检查多导睡眠图与血Hey等生化指标.结果 脑梗死伴OSA组患者的血Hcy水平为(17±5)μmol/L,显著高于无OSA组(11±3)μmol/L(P＜0 01).根据AHI值,将所有病例分为无OSA组(AHI 5～14/h)、轻度OSA组(AHI 5～14/h)、中度OSA组(AHI 15～30/h)和重度OSA(AHI＞30/h),四组的血Hcy分别为(11±3)μmol/L、(14±3)μmol/L、(17±5)μmol/L和(21±5)μmol/L,差异有统计学意义(P＜0.01),进一步组问两两比较,无OSA组均显著低于其他三组(P＜0 05).将血Hcy与AHI作Pearson相关分析,显示Hcy与AHI呈现正相关(r=0 482,P＜0 01).多元线性回归模型校正其他因素后,仍显示AHI(β=0 671,P=0.001)是血Hcy 水平的独立预测因子(R2=0.539,P＜0.01).结论 在脑梗死患者合并OSA时Hcy具有升高趋势,且随着阻塞程度的进展而加重.

Abstract：

Objective To investigate the association of plasma homocysteine and OSA (obstructive sleep apnea) syndrome in ischemic stroke (IS) . Methods A total of 92 male IS patients were classified by apnea hypopnea index (AHI) into 2 groups: non-OSA group (AHI＜5/h) and OSA group (AHI≥5). All patients were tested for plasma homocysteine when polysomnography was finished at (14±2) d after the onset of IS. Results The mean level of homocysteine was significantly higher in the OSA group than that in the non-OSA group (17±5 vs 11±3μmol/L, P＜0.01). Pearson correlation analysis revealed a positive correlation between the homocysteine level and the severity of AHI (r=0.482, P＜0.01). Further multiple linear regression analysis showed that AHI and folate were independent predictors of homocysteine level (R2=0.553, P＜0.01, β for AHI=0.671, β for folate=-0.256). Conclusion The severity of OSA is significantly associated with an elevated level of homocysteine in IS patients. And this association is independent of other causative factors of an elevated level of homocysteine.     

Elevated plasma total homocysteine in preeclampsia

OBJECTIVES: To investigate the possible association between hyperhomocysteinemia and preeclampsia. METHODS: A case-control study was carried out in the Departments of Obstetrics and Gynecology of the Ghaem Hospitals in Mashhad University of Medical Sciences, Mashhad, Iran from May 2004 to August 2006 and included 75 preeclamptic patients, 37 women with mild preeclampsia, and 38 women with severe preeclampsia, in addition we included 40 controls without pregnancy complications. Plasma total homocysteine was determined in all subjects by enzyme linked immunosorbent assay. RESULTS: The 3 groups were similar in age and body. Patients with severe preeclampsia had significantly higher mean plasma levels (13.8+/-7 mg/l) than normal pregnant women (8.8+/-2.8 mg/l) and mild pre-eclamptic women (10.4+/-2.3 mg/l) (p<0.05). CONCLUSION: Women who developed severe preeclampsia have higher plasma homocysteine levels than women who remain normotensive throughout pregnancy.