血清同型半胱氨酸及叶酸、维生素B12与脑血管病的关系

为了探讨血清同型半胱氨酸(homocysteine,Hcy)、叶酸、维生素B12水平与脑血管疾病发病及其并发症之间的关系,采用荧光偏振免疫分析法和化学发光法分析比较了148例脑血管病患者和32名对照组血清Hcy、叶酸、维生素B12水平.结果显示:血清Hcy含量在脑梗死组、脑出血组及椎-基底动脉供血不足组中均明显高于对照组(P＜0.001,P＜0.001,P＜0.01);叶酸和维生素B12的浓度明显低于对照组(P＜0.05);存在高血压、糖尿病、冠心病等并发症患者血清Hcy、叶酸、维生素B12水平与无并发症患者间无显著差异(P＞0.05);脑血管病患者中血清Hcy水平升高与否在不同并发症及无并发症患者间无显著性差异(P＞0.05).表明高Hcy血症是脑血管病发病的独立危险因素之一,与叶酸和维生素B12水平下降有关,与高血压、糖尿病和冠心病等并发症无明显关联.

The Relationship Between Cerebrovascular Disease and Homocysteine, Folate and Vitamin B12 in Serum

To investigate the relationship between cerebrovascular disease and the serum levels of homocysteine(Hcy), folate and vitamin B_ 12 , the serum levels of Hcy, folate and vitamin B_ 12 in 148 patients with cerebrovascular disease were measured by fluorescence polarization immunoassay and chemiluminescence and were compared with those in healthy controls. The result showed that the serum Hcy levels in patients with cerebral infarction, cerebral hemorrhage and vertebrobasilar ischemiay were significantly higher than those in healthy controls (P<0.001, P<0.001, P<0.01), whereas the folate and vitamin B_ 12 levels were signifieantly lower(P<0.05). These serum levels were not significantly different among the patients with or without complications such as hypertension, diabetes and coronary heart disease(P>0.05). No significantly higher ratio of increased Hcy levels was observed in patient with complications(P> 0.05 ). Our conclusion is that hyperhomocysteinemia may be a new and an independent risk factor for cerebrovascular disease. The serum Hcy level is correlated with decreased levels of folate and vitamin B_ 12 , but not obviously correlated with hypertension, diabetes and coronary heart disease.