健康成人血浆同型半胱氨酸与叶酸的水平及关系研究

目的了解西宁地区健康人群血浆同型半胱氨酸与叶酸的水平以及二者之间的关系。方法采用荧光偏振免疫分析试剂盒,对西宁地区80例健康人的血浆同型半胱氨酸（Hcy）和叶酸进行检测,同时进行人口学特征及吸烟、饮酒、饮食情况调查。结果研究人群高Hcy血症的检出率较高,为30．7％;血浆Hcy平均水平为10．49μmol／L,年龄越大,血浆Hcy水平越高,男性高于女性。研究对象总的叶酸缺乏率为57．5％,血浆叶酸平均水平为6．62±1．28nmol／L,男性叶酸水平低于女性。血浆叶酸与血浆同型半胱氨酸水平之间存在负相关。两项指标藏汉民族间差异均不显著。结论西宁地区18-24岁健康人群高Hcy血症的检出率及血浆叶酸缺乏率均较高。健康人群血浆Hcy水平与年龄、性别及叶酸水平关系密切。血浆叶酸水平与性别有关。     

血浆同型半胱氨酸与高血压病的关系探讨

目的 探讨同型半胱氨酸、叶酸和维生素B12水平变化与高血压病的关系.方法 用生物酶学法和平衡竞争放射免疫法检测80例高血压病患者血中同型半胱氨酸、叶酸、维生素B12水平,并与30例健康体检者进行对照.结果 脑血管疾病患者血清中同型半胱氨酸含量明显高于健康对照组,差异有统计学意义(P<0.05);叶酸和维生素B12水平明显低于健康对照组,差异有统计学意义(P<0.05).结论 高同型半胱氨酸血症为高血压病发病的危险因素之一,并与叶酸和维生素B12水平下降有关.     

脑梗死患者血浆同型半胱氨酸、叶酸、维生素B（12）的水平测定及意义

目的探讨血浆同型半胱氨酸、叶酸、维生素B12水平与脑梗死的关系及叶酸、维生素B12干预的影响作用。方法测定118例脑梗死患者和对照者48例血浆同型半胱氨酸、叶酸、维生素B12的水平,进行对比分析。结果脑梗死组血浆同型半胱氨酸水平显著高于对照组（P〈0.01）,血浆维生素B12的水平低于对照组（P〈0.02）,高同型半胱氨酸血症者药物干预3～4周后血浆同型半胱氨酸显著降低（P〈0.01）。结论高同型半胱氨酸血症是脑梗死的独立危险因素,给予叶酸、维生素B12干预可有效降低血浆同型半胱氨酸水平。     

缺血性脑卒中患者高同型半胱氨酸血症的危险因素的研究

目的 在缺血性脑卒中患者中探讨高同型半胱氨酸血症(Hhe)的危险因素.方法 回顾性分析,将缺血性脑卒中患者690例,分为伴Hhe组329例,不伴Hhe组361例,调查年龄、性别、症状、体征、吸烟饮酒史,是否伴高血压病、精尿病病史,血浆同型半胱氨酸(Hcy)、叶酸、维生素B12、胆周醇(TC)、甘油三酯(TG)浓度.用l...     

苦碟子对高同型半胱氨酸血症细胞凋亡的影响

目的通过大鼠灌胃给予蛋氨酸复制高同型半胱氨酸血症动物模型,观察苦碟子对高同型半胱氨酸血症大鼠动脉病理变化和细胞凋亡的影响。方法将雌性Wistar大鼠共28只随机分为模型组（n=8）、空白对照组（n=7）、叶酸＋VitB12组（n=7）和苦碟子组（n=6）。除空白对照组外,其他组每天2次灌胃给予蛋氨酸0．75kg,连续10周,复制高同型半胱氨酸血症动物模型。叶酸＋VitB12组和苦碟子组同时给予叶酸＋VitB12和苦碟子干预。检测各组大鼠血浆同型半胱氨酸、Caspase-3含量及动脉病理变化和平滑肌凋亡细胞计数。结果模型组大鼠灌胃给予蛋氨酸后血浆同型半胱氨酸、Caspase-3含量和平滑肌凋亡细胞计数均较空白对照组升高（均P〈0．01）;苦碟子组血浆Caspase-3含量和平滑肌凋亡细胞计数与模型组比较降低（均P〈0．01）。结论高蛋氨酸可诱发高同型半胱氨酸血症,引发动脉粥样硬化。苦碟子对高同型半胱氨酸血症诱发的动脉粥样硬化具有预防作用．其机制与抑制细胞凋亡相关。     

脑卒中病人血浆中同型半胱氨酸含量的检测(摘要)

我们对98例脑卒中病人血浆中同型半胱氨酸(Hcy)、叶酸(FA)和维生素B12(Vit B12)的含量进行了检测,以探讨高同型半胱氨酸血症与脑卒中的关系,现报告如下.     

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。     

冠心病患者血液中同型半胱氨酸的相关检测及意义

目的:对冠心病患者血液中同型半胱氨酸进行相关检测,并探讨其在冠心病患者中的临床意义.方法:实验组为该院确诊的60例冠心病患者,对照组是60例体检合格的健康人员.采用循环酶法测定同型半胱氨酸的水平,微粒子酶免疫分析法测定血浆叶酸的浓度、维生素B12的浓度,直接方法检测低密度脂蛋白胆固醇的含量,运用免疫比浊法测定超敏C反应蛋白的水平;最后对测量的结果进行分析.结果:实验组同型半胱氨酸与低密度脂蛋白胆固醇、超敏C反应蛋白水平明显高于对照组,实验组叶酸、维生素B1 2水平明显低于对照组,两组测量值比较,差异有统计学意义(P＜0.01).结论:高同型半胱氨酸血症与低密度脂蛋白胆固醇、超敏C反应蛋白及叶酸、维生素B12相关,是冠心病发生的独立危险因素.所以,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具有重要的意义.     

叶酸和维生素B12联合治疗脑梗死患者高同型半胱氨酸血症

目的：观察叶酸和维生素B12联合治疗脑梗死患者高同型半胱氨酸血症的疗效。方法：将60例脑梗死伴高同型半胱氨酸血症患者随即分为2组,联合组（应用叶酸联合维生素B12）与叶酸组（应用叶酸）,疗程均为4周。观察两组患者血浆中同型半胱氨酸含量。结果：两组患者的同型半胱氨酸水平有不同程度的下降,联合组下降水平明显低于叶酸组。结论：叶酸和维生素B联合治疗脑梗死高同型半胱氨酸血症效果显著。     

苦碟子对高同型半胱氨酸血症血管内皮的保护作用

目的 通过兔高蛋氨酸饮食复制高同型半胱氨酸血症动物模型,观察苦碟子对高同型半胱氨酸血症对动脉血管内皮细胞的影响.方法 雄性新西兰兔喂食高蛋氨酸饲料(基础饲料中加入1.7%蛋氨酸)8周复制高同型半胱氨酸血症动物模型.光镜检察各组动物胸主动脉的病理改变,检测血浆同型半胱氨酸、一氧化氮(NO)含量和一氧化氮合酶(NOS)活性,组间比较t检验.结果 模型对照组大鼠灌胃给予蛋氨酸可诱发高同型半胱氨酸血症(与空白对照组比较,P＜0.01),血浆(含量降低(与空白对照组比较,P＜0.01),NOS活性降低(与空白对照组比较,P＜0.01),苦碟子及叶酸、B12干预可抑制高同型半胱氨酸血症引发的动脉粥样硬化,NOS活性升高(与模型对照组比较,P＜0.01),血浆同型半胱氨酸浓度下降,NO含量升高(与模型对照组比较,P＜0.01).结论 高蛋氨酸可诱发高同型半胱氨酸血症,引发动脉粥样硬化.苦碟子及叶酸、维生素B12对高同型半胱氨酸血症诱发的动脉粥样硬化具有预防作用,并且对其引起的血管内皮损伤有保护作用.     

The effect of polymorphisms of MTHER gene and vitamin B on hyperhomocysteinemia

Recent studies have shown that moderate eleva-tion of plasma total homocysteine( Hcy) ,termedmoderate hyperhomocysteinemia was related to coro-nary artery disease ( CAD) [1,2 ] .Hcy is a thiol aminoacid generated from metabolism of methionine.There are two pathways in mammals:remethylationof Hcy to methionine and transsulfuration of it tocysteine,each accounting for about5 0 % of Hcy dis-posal.N5 ,N1 0 - methylenetetrahydrofolate reductase( MTHFR) and cystathionine-β- synthase ( CBS) ar…     

脑血管病患者血浆同型半胱氨酸浓度及相关因素分析

目的: 探讨高同型半胱氨酸(Hcy)血症及其相关因素与脑血管病的关系。方法: 选择年龄及性别基本匹配的脑梗死组60例、脑出血组30例、神经系统其他疾病组30例和正常老年人组30名,采用酶联免疫分析法测定入选者血浆Hcy浓度,并同时测定血叶酸、维生素B₁₂。结果: 脑梗死组和脑出血组血Hcy浓度明显高于神经内科其他疾病组和正常老年人组(P<0.01)。相关回归分析显示:梗死组和脑出血组Hcy与叶酸、维生素B₁₂存在负相关。结论: 高Hcy血症与脑血管病相关。补充叶酸、维生素B₁₂可能有助于降低这一危险因素。     

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.     

Preventive health care, 2000 update: screening and management of hyperhomocysteinemia for the prevention of coronary artery disease events

OBJECTIVE: To establish guidelines for the screening and treatment of hyperhomocysteinemia in the investigation and management of coronary artery disease (CAD). OPTIONS: Measurement of plasma total homocysteine (tHcy) levels in the fasting state or 4-6 hours after oral methionine load; vitamin supplementation with folic acid and vitamins B6 and B12; adherence to the recommended daily allowance of dietary sources of folate and vitamins B6 and B12. OUTCOMES: This article reviews the available evidence on the association between plasma tHcy levels and CAD and the effect of lowering tHcy levels through vitamin supplementation or dietary intake. EVIDENCE: MEDLINE was searched for relevant English-language articles published from January 1966 to June 1999; also reviewed were additional articles identified from the bibliographies. BENEFITS, HARMS AND COSTS: Cardiovascular disease is the leading cause of death in Canada. Homocysteine, generated in the metabolism of methionine, may have a role in the development of cardiovascular disease. The prevalence of hyperhomocysteinemia in the general population is between 5% and 10% and may be as high as 30%-40% in the elderly population. If population-based studies are correct, tHcy may be responsible for up to 10% of CAD events and thus may represent an important and potentially modifiable risk factor for cardiovascular disease. Laboratory testing for tHcy is currently restricted to research centres, and costs range from $30 to $50 per person. Newer, less costly techniques have been developed and should become readily available with time. VALUES: The strength of evidence was evaluated using the methods of the Canadian Task Force on Preventive Health Care. RECOMMENDATIONS: Although there is insufficient evidence to recommend the screening or management of hyperhomocysteinemia at present (grade C recommendation), adherence to recommended daily allowance of dietary sources of folate and vitamins B12 and B6 should be encouraged. If elevated tHcy levels are discovered, vitamin deficiency should be ruled out to allow specific treatment and prevention of complications, such as neurological sequelae due to vitamin B12 deficiency. Experts in the field advocate treatment of elevated tHcy levels in high-risk people, such as those with a personal or family history of premature atherosclerosis or a predisposition to develop hyperhomocysteinemia. Definitive guidelines for the management of hyperhomocysteinemia await the completion of randomized trials to establish the effect of vitamin supplementation on CAD events. VALIDATION: The findings of this analysis were reviewed through an iterative process by the members of the Canadian Task Force on Preventive Health Care. SPONSORS: The Canadian Task Force on Preventive Health Care is funded through a partnership between the Provincial and Territorial Ministries of Health and Health Canada.     

Methylmalonic Acid in Amniotic Fluid and Maternal Urine as a Marker for Neural Tube Defects~

Neuraltubedefects (NTDs) ,ariseduetofailureofclosureoftheneuraltube,encompassingcraniorachis chisistotalis,anencephaly ,myeloschisis,encephaloce les,andmeningomyeloceles (andArnold Chiarimalfor mation) ,areamongthemostcommonneurologicaldevel opmentalbirth…     

两种清除法测定低密度脂蛋白胆固醇的临床评价

目的对表面活性剂清除法 (SUR法 )和过氧化氢酶清除法 (CAT法 )两种低密度脂蛋白胆固醇 (LDL C)均相测定法进行临床评价。方法将上述两种方法与聚乙烯硫酸沉淀法 (PVS法 )进行比较 ,分析各自方法的精密度、准确性、特异性和干扰因素。结果两种清除法与PVS法 (X)具有良好的相关性 ,SUR法 (Y1) :Y1=0 .9311X +0 .10 2 2 ,r =0 .980 1;CAT法 (Y2 ) :Y2 =0 .94 0 1X +0 .0 991,r=0 .9832。高、中、低三种LDL C浓度混合血清所测定结果表明两种方法均具有良好的精密度 ,总CV值SUR法 3.4 5 - 3.89% ,CAT法 3.5 1- 3.99% ,均达到临床满意的程度。两法线性范围均较宽 (线性均至 8.2 2mmol/L) ,最低检测浓度均为 0 .12mmol/L ,平均回收率SUR法为 98.0 % ,CAT法为 97.6 %。TG <14 .2mmol/L ,Hb <5g/L ,HDL C <3.88mmol/L ,胆红素 <4 5 0 μmol/L对两法基本无影响。 结论两种LDL C清除法测定结果的准确度和精密度均符合临床要求 ,适宜自动分析 ,值得在临床推广应用。     

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。     

阿尔茨海默病患者血浆同型半胱氨酸、叶酸和维生素B12的含量变化

目的 探讨阿尔茨海默病（AD）患者血浆同型半胱氨酸（Hcy）、叶酸和维生素B12的含量,短期叶酸和维生素B12干预AD患者后,观察血浆Hcy的含量变化,以及认知功能和日常生活能力的改变.方法 入组AD患者126例,进行基线MMSE和ADL的评定;正常对照组120例.空腹采取静脉血3ml,离心后取血浆测定Hcy、叶酸和维生素B12浓度.AD组给予叶酸和维生素B12干预4周,再进行血浆Hcy和MMSE及ADL的评定.结果 AD组血浆Hcy、叶酸和维生素B12分别是（18.69＆#177;4.57） μmol/L、（10.86 ＆#177;3.96） nmol/L、（266.62＆#177;42.38） pmol/L;正常对照组分别是（10.23＆#177;2.85） μmol/L、（15.92＆#177;4.45） nmol/L、（335.90＆#177;95.58） pmol/L.AD组血浆Hcy高于正常对照组,差异有统计学意义（P＜0.05）,而叶酸和维生素B12低于正常对照组,差异有统计学意义（P＜0.05）.叶酸5 mg（3次/d）和维生素B12 500 mg（1次/d）干预AD组4周后,血浆Hcy水平显示差异有统计学意义（P＜0.05）,而MMSE、ADL治疗前后比较差异无统计学意义（P＞0.05）.结论 AD患者血浆中Hcy显著升高,而叶酸和维生素B12显著下降,叶酸和维生素B12短期干预AD患者没能显示改善认知功能和日常生活能力的改善.