同型半胱氨酸与老年人心脑血管病变关系的研究

目的　比较血清同型半胱氨酸 (HCY)、叶酸、维生素B12 等与原发性高血压、冠心病、脑卒中病变的关系 ,探讨其血浓度在预测老年人心、脑血管病变中的意义 .方法　对 2 2 4例患原发性高血压、冠心病、脑卒中患者和 10 6例健康体检正常的对照组应用荧光偏振法 (FPIA)分析血清HCY和用微粒子酶免疫分析 (MEIA)测定血清叶酸、VitB12 水平并比较各组间差异 .结果　心肌梗死组、脑溢血和脑梗死患者的血清HCY水平显著高于正常对照组 (p <0 .0 1) ,而叶酸浓度则明显低于正常对照组 (p<0 .0 1) .VitB12 含量仅在脑梗死组中低于正常对照组 .单纯原发性高血压组和心绞痛组的血清HCY和叶酸的含量与正常对照组比较无差异 .在冠心病、脑卒患者中血清HCY浓度与血清叶酸浓度呈负相关 (r=- 0 .6 0 8,p<0 .0 1;r=- 0 .6 87,p<0 .0 1) .结论　在老年人群中血清HCY浓度增高与低叶酸水平是冠心病、脑血管疾病的一个重要危险因素 .用荧光偏振 (FPIA)法检测血清HCY浓度可作为评价和预测心、脑血管疾病的一个敏感可信的指标

Association Between Serum Homocysteine and Cardiac,Cerebrovascular Disease in Older Persons

Objective To investigate the relationship between homocysteine(HCY), folate, vitamin B 12 (VitB 12 )and the primary hypertension, coronary artery disease,cerebral stroke and the significance of their levels in predicting cardiac, cerebral vascular events of older patients. Methods Serum HCY concentration was measuned using Fluorescence Polarization Immunoassary(FPIA) and serum folate,vitB 12 concentration was measured using,Microparticle Enzyme Immunoassay(MEIA)in 224 patients with the primary hypertension, angina pectoral, myocardial infarction group, cerebra hemorrhage and cerbra infarction and 106 normal cases selected from health check. Results The results showed that patients with myocardial infarction group, cerebra hemorrhage and cerbra infarction group had significantly higher HCY levels than controls and that their was lower folate levels than controls. The difference was not significantly in serum HCY and folate from patients with primary hypertension, angina pectoral group and normal controls.The serum HCY and folate were negatively correlated in patients with coronary artery disease, and cerebral stroke. r=- 0.608 ,p<0.01, r=-0.687 ,p<0.01. Conclusions It is suggested that the elevated serum HCY and low serum folate levels were an important risk factor of coronary artery disease, cerebrovascular disease in older population. The application of the FPIA method for HCY detection are sensitive and reliable index for evaluating and predicting the cardiac,cerebral vascular disease.