血清同型半胱氨酸在慢性阻塞性肺病中的临床意义

目的:探讨测定慢性阻塞性肺疾病(COPD)患者血清总同型半胱氨酸(tHCY)的临床意义.方法:年龄在65岁以上的COPD急性加重住院患者45例(第1组)、COPD稳定期患者42例(第2组)及年龄、性别与其匹配的无症状患者40例(对照组),测定其第1秒用力呼气客积(FEV1)、用力肺活量(FVC)和圣乔治呼吸问卷(SGRQ)计分及血清总同型半胱氨酸(tHCY)、叶酸、维生素Bt2和前白蛋白(PA)浓度.结果:在SGRQ计分、FEV1、FEV1/FVC和PA水平方面,第1组和第2组均显著低于对照组(P＜0.001),而第1组又显著低于第2组(P＜0.05).此外,在tHCY水平方面,第1组和第2组均显著高于对照组(P＜0.001),而第1组又显著高于第2组(P＜0.001).多元线性回归分析显示:tHCY水平与叶酸、VitB12呈负相关.结论:COPD患者血清tHCY显著高于对照组,监测和降低同型半胱氨酸的浓度具有一定的临床意义.

Clinical Significance of Serum Homocysteine in COPD Patients

Objective：To explore clinical significance of total serum homocysteine（tHCY） detection in chronic obstructive pulmonary disease（COPD） patients.Methods：We studied 45 COPD patients with exacerbations（group 1）,42 patients with stable COPD（group 2） and 40 asymptomatic subjects（controls） over age 65 years with measurement of forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）,St.Georges Respiratory Questionnaire（SGRQ） score,serum tHCY,folate, VitB12 and prealbumin（PA）.Results：In SGRQ score,FEV1,FEV1/FVC and PA levels,they were significantly lower in group 1 and group 2 than in control（P〈0.001）,while they were significantly lower in group 1 than that in group 2（P〈0.05）. In addition,the levels of tHCY were significantly higher in group 1 and group 2 than in control（P〈0.001）,while they were significantly higher in group 1 than that in group 2（P〈0.001）.Multivariate regression analysis showed that tHCY was negatively correlated with folate and VitB12.Conclusions：Total serum homocysteine is significantly elevated in COPD patients relative to age and sex-matched controls,monitoring and reducing homocysteine concentrations have important clinical significance.