下肢深静脉血栓形成患者不同部位血同型半胱氨酸、叶酸和维生素B12水平测定及意义

目的探讨高同型半胱氨酸血症与下肢深静脉血栓形成（DVT）之间的关系。方法90例DVT患者为病例组，90例健康体检者为对照组，同时病例组中40例进行自身对照。血同型半胱氨酸（Hcy）、叶酸和维生素B12（VitB12）水平采用全自动化学发光免疫分析系统测定。结果病例组外周血Hcy总体水平高于对照组（P〈0．01），血栓局部血浆Hcy总体水平高于对照组（P〈0．01）；血栓局部与外周血Hcy总体水平相比虽轻度升高，但无统计学意义。在原发性DVT患者中，高同型半胱氨酸血症发生率高于继发性DVT患者，差异有统计学意义。结论①高同型半胱氨酸血症是DVT的危险因素之一，对于原发性DVT致病作用更为显著。②采用导管局部采样测定的局部血浆Hcy数据能更加客观和真实地反映体内血浆Hcy水平。

Determination and its significance of levels of plasma homocystine, serum folic acid and vitamin B12 in different situs in patients with deep vein thrombosis of lower extremities

Objective To investigate the association between hyperhomocysteinemia and deep thrombosis of lower extremities. Methods 90 patients with deep venous thrombosis of lower extremities and 90 normal healthy examinees were designated as the case group and the control group. Of the case group, 40 cased were selected for self control. Auto- mated chemiluminescence assay was used to determine the levels of plasma homocystine, serum folic acid and vitamin B12. Results The case group, in general, had statistically higher peripheral plasma homoeystine levels than the control group. However, when compared with the self control group, the slight increase in peripheral plasma homoeystine levels was of no statistical significance. The prevalence of hyperhomoeysteinemia was higher in patients with idiopathic deep venous thrombosis of lower extremities than those with secondary deep venous thrombosis. The differences were considered statistically significant. Conclusion （1）Hyperhomocysteinemia is one of risk factors in deep vein thrombosis of lower extremities, which is more evident in idiopathic deep vein thrombosis of lower extremities. （2）Local plasma homoeystine data determined by catheterization for local sampling are more objective and veritable in reflecting homocystine levels in vivo.