同型半胱氨酸的检测及其应用

同型半胱氨酸(homocysteine,Hcy)是一种含硫氨基酸,是甲硫氨酸(methionine,Met)代谢过程中的一种重要中间产物.     

血同型半胱氨酸检测的临床意义

同型半胱氨酸(HCY)是一种含硫的氨基酸,是蛋氨酸转化成半胱氨酸代谢过程中能量代谢的一个重要中间产物,主要通过再甲基化途径、转硫化途径释放到细胞外液代谢。它的致病机理主要包括损伤血管内皮细胞、促进血管平滑肌细胞增殖、影响凝血系统及脂质代谢。大量研究表明HCY与心脑血管疾病等常见临床疾病有着密切的关系,本文就HCY研究的进展综述如下。     

同型半胱氨酸检测参考值范围的探讨

目的确立同型半胱氨酸(HCY)检测的参考值范围。方法通过Olympus AU2700全自动生化分析仪,对2 033例标本进行分析,检测HCY,以确定HCY的参考值范围。结果 HCY≤10μmol/L的检测值人数为1 520例,占检测人数的74.76%;10.1～14.9μmol/L的检测值人数为296例,占检测人数的14.55%;≥15μmol/L的检测值人数为217例,占检测人数的10.67%。结论 HCY≤10μmol/L为正常参考值,>10～<15μmol/L为临界参考值,在此水平的HCY,可根据患者的病理情况做进一步分析认证;HCY≥15μmol/L为异常参考值。高HCY血症的男性人数明显多于女性。     

同型半胱氨酸检测在临床上的应用

同型半胱氨酸(homocysteine,Hcy)又称高半胱氨酸,是一种与半胱氨酸同系的含硫非必需氨基酸,是蛋氨酸循环的正常代谢产物,人类不能从食物中直接获得,只有蛋氨酸在体内代谢后形成.健康成人血浆Hcy浓度为5～15μmol/L,儿童明显低于成人.随着年龄的增长,血浆Hcy浓度浓度逐渐增加[1].由于高Hcy血症在动脉粥样硬化和血栓栓塞性疾病的发生中起重要作用,一直以来被认为是心血管疾病的独立危险因素之一[2].近年来通过大量的研究表明,高Hcy还与肿瘤、老年性痴呆等其他疾病相关,从而使Hcy在临床应用领域大大增加,其在医学上的价值正得到广泛验证和承认,现将其临床应用综述如下.     

脑梗死患者血清同型半胱氨酸水平分析

目的分析脑梗死患者血清同型半胱氨酸水平。方法选取2014年8月至2015年7月德宏州人民医院神经内科收治的186例脑梗死患者作为研究对象,与同期来医院做健康体检的1 763例体检者进行同型半胱氨酸(HCY)水平比较。结果脑梗死组HCY平均浓度高于体检组,差异有统计学意义(P0.05);男性组和女性组HCY平均浓度差异明显(P0.05);女性脑梗死组与女性体检组HCY浓度比较差异无统计学意义(P0.05)。结论同型半胱氨酸在脑梗死患者的诊治中有一定的价值,其浓度水平特别在男性患者中增高明显,值得临床进一步分析和研究,常规开展同型半胱氨酸检测,利于疾病的诊治和预防。     

脑梗死患者血浆同型半胱氨酸检测的临床意义

目的探讨脑梗死与血浆同型半胱氨酸（HCY）水平的关系。方法对120例脑梗死患者测定血浆HCY、叶酸、维生素B12等指标。并与60例健康对照者相比较。结果脑梗死组的血浆HCY水平和甘油三酯明显高于对照组，而叶酸及维生素B12水平则低于对照组（均P〈0．01）；脑梗死与HCY水平之间存在危险性的水平梯度，当HCY〉15μmol／L时，发生脑梗死的危险性为正常人的5．909倍，而HCY≥20μmol／L时，患者发生脑梗死的危险性为正常人的10．545倍；各项监测指标的相对危险性显示。与脑梗死有关的因素分别为HCY、叶酸、维生索B12、甘油三酯和收缩压、舒张压。条件Logistic回归模型检验发现HCY、甘油三酯、高密度脂蛋白和收缩压为脑梗死的独立致病因素；脑梗死组和对照组血浆HCY水平与血叶酸潍生素B12水平均呈显著负相关性。结论高同型半胱氨酸血症是脑梗死的独立致病因素。导致高同型半胱氨酸血症的原因可能是血浆内叶酸和维生素B12的降低。     

同型半胱氨酸的检测

同型半胱氨酸 ( homocysteine,Hcy)是一种含硫氨基酸 ,为甲硫氨酸 ( methionine,met)代谢过程中的重要中间产物。血浆中存在的 Hcy形式多样 ,所有形式的 Hcy称为总同型半胱氨酸 ( t Hcy) [1] 。目前检测 t Hcy的方法很多 ,每种方法都有其优缺点 ,且测定结果各不相同。为此 ,我们对 t Hcy的检测及分析前影响作一综述 ,供研究时选择检测方法作参考。方法学一、最早测定 Hcy的方法1 962年在对 1例先天性 Hcy尿症病人的诊断时引入了 Hcy的测定。当时用简单化学方法和氨基酸分析仪检测。到 70年代中期 ,第二代氨基酸分析仪可检出健康人血清中…     

同型半胱氨酸的检测

同型半胱氨酸(homocysteine, Hcy)是一种含硫氨基酸,为甲硫氨酸(methionine, met)代谢过程中的重要中间产物。血浆中存在的Hcy形式多样,所有形式的Hcy称为总同型半胱氨酸(tHcy)［1］。 目前检测tHcy的方法很多,每种方法都有其优缺点,且测定结果各不相同。为此,我们对tHcy的检测及分析前影响作一综述,供研究时选择检测方法作参考。 方法学     

106例心脑血管患者血清同型半胱氨酸测定结果分析

目的探讨心脑血管患者血清同型半胱氨酸（Hcy ）水平与血脂含量变化间的关系。方法采集所有参与本试验对象的晨起空腹静脉血3 mL ,1 h内离心分离血清,采用酶法测定血清 Hcy、总胆固醇（TC）、三酰甘油（TG）。结果冠心病、脑梗死患者的血清Hcy水平明显高于健康对照组,心脑血管患者高Hcy血症的血清Hcy水平明显高于健康对照组,差异均有统计学意义（P＜0．05）。结论高 Hcy血症是心脑血管疾病患者的独立致病危险因素。     

102例男性查体者血清同型半胱氨酸检测分析

[目的]探讨血清中同型半胱氨酸（HCY）与中年男性动脉硬化的相关性。[方法]采集受试者空腹肘静脉血,采用全自动生化分析仪循环酶法对3组（动脉硬化组,无动脉硬化组和健康组）总计102例男性查体者的HCY进行检测,采用全自动动脉硬化测定仪检测PWV（cm／s）数值。[结果]有动脉硬化组血清HCY及PwV数值均明显高于对照组（P〈0．01）;而无动脉硬化组血清HCY及PwV数值与健康组比较差异无显著性（P〉0．05）。[讨论]研究显示,体检时通过检测血清HCY和全自动动脉硬化测定仪,可早期发现早期干预血管病变的发生,是防止和延缓控制心脑血管疾病的根本措施。同时将两种方法用于普通健康人群检查,对早期血管壁的硬度及弹性改变、心脑血管疾病诊治和亚健康的评价具有重要的临床指导意义。     

Folate and cobalamin synergistically decrease the risk of high plasma homocysteine in a nonsupplemented elderly institutionalized population

OBJECTIVE: Total plasma homocysteine (tHcy) has been associated with an increased risk of cardiovascular disease in the general population and elderly subjects are at high risk of elevated homocysteine because of an impaired vitamin status. The aim of the present study was to determine the independent and interactive association of adequate folate and cobalamin (intake and serum levels) with tHcy in elderly subjects who were not taking vitamin supplementation. DESIGN AND METHODS: Cross-sectional analysis of a sample of 140 elderly recruited from seven nursing homes in Asturias (Northern Spain). Dietary intake was assessed by a food frequency questionnaire, and serum folate, cobalamin, and tHcy were determined in fasting blood samples. RESULTS: Mean tHcy concentration was 13.3 micromol/L (upper quartile of tHcy >16.0 micromol/L) and was inversely correlated with serum folate. Subjects with an adequate intake or serum levels of both folate and B12 were at a reduced risk of being in the highest quartile of tHcy. In both cases, the reduction of high tHcy (upper quartile) risk was found to be greater than expected when subjects with high levels of both vitamins were considered together. CONCLUSIONS: Adequate folate and cobalamin (both intake and serum levels) act synergistically to decrease the risk of high total plasma homocysteine levels in this elderly population.     

Homocysteine level and metabolism in ischemic stroke in the population of Northern Poland

Objectives:

In this study we analyzed the occurrence of ischemic brain stroke in Northern Poland in regard to risk factors.

Design and methods:

131 ischemic stroke patients and 64 controls were studied. Analyzed risk factors included conventional risk factors, total plasma homocysteine level and polymorphisms of the main enzymes of homocysteine metabolism—methylenetetrahydrofolate reductase (polymorphisms C677T and A1298C) and cystathionine β synthase (polymorphism T833C).

Results:

We confirmed the occurrence of a number of conventional risk factors in ischemic stroke. We found that hyperhomocysteinemia is an independent risk factor (p = 0.0001). Plasma homocysteine correlated inversely with plasma vitamin B₆. We also found a relationship between C677T polymorphism type and hyperhomocysteinemia (p = 0.0266).

Conclusions:

The occurrence of studied polymorphisms in the population of northern Poland was higher than reported previously for similar populations. However, none of the studied genetic factors were found to be significant risk factors in ischemic brain stroke.     

血浆同型半胱氨酸与脑卒中相关性研究

目的:研究血浆同型半胱氨酸(Hcy)与卒中的不同类型、病变程度、病变部位的关系。方法:采用荧光偏振免疫分析法测定135例脑卒中患者(卒中组)和53例健康者(对照组)血浆Hcy含量,卒中组同时记录神经功能缺损评分、血压、血糖、血脂,并进行多元线性回归分析。结果:卒中组血浆Hcy含量明显高于对照组(P<0.05),并且随病情程度加重而升高(P<0.01)。血浆Hcy含量与神经功能缺损评分存在正线性关系。无论病灶位于基底核、脑叶还是脑干,其Hcy含量均无显著性差异。结论:急性脑卒中患者血浆Hcy含量反映其病情的严重程度,有助于评估预后,指导临床治疗。     

慢性肾衰竭患者血浆同型半胱氨酸检测的临床应用

目的 研究慢性肾衰竭（chronic renal failure,CRF）患者血浆总同型半胱氨酸（total homocysteine,tHcy）浓度的变化.方法 采用循环酶法测定176例CRF患者和147例健康人血浆tHcy的含量,并进行统计分析.结果 血浆tHcy浓度CRF患者显著高于正常对照组（P〈0.01）,且V期患者显著高于Ⅳ期患者（P〈0.01）,Ⅳ期患者显著高于Ⅲ期患者（P〈0.01）.结论 CRF患者血浆tHcy浓度明显升高,且随着病情的加重,血浆tHcy浓度呈逐渐上升趋势,检测血浆tHcy浓度对了解CRF患者病情具有重要意义.     

细菌性阴道病在女性体检人群中的调查分析

目的了解细菌性阴道病(BV)在女性体检人群中的流行情况。方法用化学反应法对福州地区4 476例来该院体检的妇女进行BV检测,同时用常规方法进行滴虫、真菌检查。结果 4 476份阴道分泌物标本中,检出BV阳性534例,阳性率为11.9%,检出滴虫17例,阳性率为0.4%,检出真菌185例,阳性率为4.1%,其中单纯BV阳性470例(88.0%)、BV阳性合并滴虫12例(2.3%)、BV合并真菌阳性52例(9.7%);按年龄分组,21～30岁组BV阳性率最高,为15.0%,≥61岁组最低,为3.6%,BV阳性检出率在各年龄组之间存在明显差异(∑χ2=24.63,P<0.05)。结论福州地区女性体检人群BV患病率较高,明显高于滴虫及真菌的检出率,且年龄差异明显,因此,建议在女性体检人群中常规开展BV检查,以便及时发现和治疗。     

巨幼细胞性贫血患者同型半胱氨酸检测的意义

目的检测巨幼细胞性贫血患者同型半胱氨酸水平,证实在叶酸、维生素B12缺乏性疾病时同型半胱氨酸水平是否升高?单纯升高的同型半胱氨酸是否造成冠状动脉硬化?方法同型半胱氨酸水平检测用酶免疫分析法,叶酸、维生素B12检测用放射免疫分析法,肌红蛋白、肌钙蛋白用胶体金法,CK-MB用免疫抑制法,TC用酶法比色法,LDL用免疫透射比浊法.结果巨幼细胞性贫血患者同型半胱氨酸水平(23.4±7.80μmol/L)比对照组(13.50±3.00μmol/L)和其他贫血组(12.80±2.50μmol/L)明显升高(P<0.01).结论巨幼细胞性贫血患者同型半胱氨酸水平明显升高,但单纯同型半胱氨酸水平明显升高的18例患者无一例导致冠状动脉硬化,同时合并有高TC、LDL的3例患者中2例出现心肌损害,高同型半胱氨酸导致的冠状动脉硬化是一个多因素过程,其中有高TC、LDL参与.     

同型半胱氨酸与缺血性脑卒中关系的探讨

目的探讨同型半胱氨酸(Hcy)水平与缺血性脑卒中(ischemicstroke)的关系。方法187例住院患者,分为缺血性脑卒中组93例及对照组94例,用高效液相色谱仪和荧光检测仪测定两组血浆总Hcy水平,并分析Hcy水平与糖尿病、高血压、年龄、性别、血脂各指标之间的关系。结果Hcy水平:(1)与糖尿病、高血压、年龄、性别、血脂各指标之间无明显相关关系;(2)缺血性脑卒中组显著高于对照组。结论Hcy水平升高与缺血性脑卒中密切相关,高同型半胱氨酸血症是缺血性脑卒中发病的一个独立危险因素。     

Increased level of serum Homocysteine in vitiligo

Background: Vitiligo is an acquired depigmenting disorder caused by the destruction of melanocytes. The exact etiopathogenesis and mechanisms of vitiligo are not fully understood. Vitamin B12 and folic acid levels are decreased in vitiligo, which are the important cofactors required in the metabolism of Homocysteine (Hcy). Consequently, Hcy level increases in the circulation. Therefore, it is possible that increased Hcy plays a role in melanocytes destruction. The aim was to study for any association of vitiligo with serum Hcy level. Method: A total of 30 vitiligo patients of both sexes and 30 control subjects were enrolled in this study. Sera from patients and controls were assayed for Hcy by Enzyme immunoassay. The collected data were analyzed by SPSS version‐16. Results: The mean serum level of Hcy was significantly higher in patients with vitiligo as compared with healthy controls and its level was high in male patients as compared with female patients. The Hcy level in vegetarian patients was significantly higher as compared with nonvegetarian patients. The Hcy level was also significantly higher in active vitiligo patients as compared with stable vitiligo patients. Conclusion: An increased serum Hcy may be a precipitating factor for vitiligo in the predisposed individuals. Serum Hcy is related to the gender of patients, activity of disease, and dietary habits of vitiligo patients. J. Clin. Lab. Anal. 25:110–112, 2011. © 2011 Wiley‐Liss, Inc.     

7种肿瘤患者血浆同型半胱氨酸水平的初步探讨

目的同型半胱氨酸(H cy)作为一种含硫氨基酸是蛋氨酸代谢的中间产物。一些研究报道,同型半胱氨酸在几种肿瘤中表达水平升高。该文旨在研究同型半胱氨酸在更多种类肿瘤中的表达水平。方法收集7种肿瘤(结直肠癌、原发性肝细胞癌、乳腺癌、膀胱癌、肾癌、胃癌和食管癌患)患者和健康人的血浆,共402份,测定其中总同型半胱氨酸及叶酸、维生素B12的浓度,然后,通过统计学方法,比较7种肿瘤患者血浆总同型半胱氨酸及叶酸、维生素B12的测定结果与健康人有无差异。结果血浆总同型半胱氨酸测定结果:结直肠癌、原发性肝细胞癌、乳腺癌、膀胱癌、肾癌、胃癌和食管癌7组血浆总同型半胱氨酸水平与健康对照组比较,均有统计学差异,水平升高(P<0.05),而叶酸与健康对照组比较水平降低(P<0.05),维生素B12与健康对照组比较无统计学上显著差异(P>0.05)。结论同型半胱氨酸在肿瘤中的升高可能具有普遍性。