叶酸联合甲古胺对妊娠期高血压疾病患者高同型半胱氨酸血症的影响

目的　研究血浆总同型半胱氨酸 (tHcy)水平与妊娠期高血压疾病的关系及叶酸联合甲古胺对其的影响。方法　 2 0 0 1年 1月至 2 0 0 3年 6月广东省东莞市人民医院采用荧光偏振免疫分析法测定 16 2例妊娠期高血压疾病患者和 15 0例正常晚期妊娠妇女血浆tHcy水平 ,同时采用离子捕捉免疫分析法检测其血清叶酸水平和微粒子酶联免疫分析法检测其血清VitB1 2 水平 ,并对 36例合并高Hcy血症的患者采用叶酸联合甲古胺进行干预治疗 ,4周后再次测定其血浆tHcy水平、血清叶酸和VitB1 2 水平。结果　妊娠期高血压疾病患者血浆tHcy水平显著高于正常妊娠组 (P <0 0 1) ,血清叶酸和VitB1 2 水平显著低于正常妊娠组 (P <0 .0 5 ) ;36例合并高Hcy血症的患者治疗后血浆tHcy水平比治疗前显著下降 (P <0 0 1) ,而血清叶酸和VitB1 2 水平比治疗前则显著升高 (P <0 0 5 )。结论　高Hcy血症是妊娠期高血压疾病发病的重要因素之一 ,应用叶酸联合甲古胺治疗 ,可显著降低妊娠期高血压疾病合并高Hcy血症患者的血浆tHcy水平 ,减少高Hcy对血管的毒性作用 ,有助于改善妊娠期高血压疾病患者的疾病转归。

Effects of folic acid combined with methylcobalamin on hyperhomocysteinemia in patients with hypertensive disorder complicating pregnancy

Objective To investigate the relationship between plasma total homocysteine(tHcy) and hype rtensive disorder complicating pregnancy.In addition,the effects of folic acid c ombined w ith methylcobalamin on hyperhomocysteinemia in patients with hypertensive disord er complicating pregnancy. Methods From January 2001 to June 2003,162 cases of hypertensive disorder complicating p regnancy and 150 cases of normal late pregnancy were enrolled.The plasma levels of tHcy were measured using fluorescence polarization immunoassay(FPIA),and seru m folic acid concentrations were measured by ion capture immunoassay(ICIA),and s erum VitB 12 concentrations were measured by microparticle enzyme immunoass ay(MEIA).36 hypertensive disorder complicating pregnancy patients with hyperhomo cysteinemia received folic acid combined with methylcobalamin administration.Th e plasma levels of tHcy and the levels of serum folic acid and VitB 12 we re measured again after four weeks.Results The plasma levels of tHcy in hypertensive disorder complicating pregnancy patien ts was significantly higher than that in normal late pregnancy(P<0. 01),and the levels of serum folic acid and VitB 12 was significantly lower than tho se in the normal late pregnancy(P<0.05).After four weeks of folic a cid combined with methylcobalamin administration,the plasma levels of tHcy in 36 hyperten sive disorder complicating pregnancy patients with hyperhomocysteinemia was sign ificantly decreased(P<0.01),and the levels of serum folic acid and VitB 12 was significantly increased(P<0.05). Conclusion Hyperhomocysteinemia plays an important role in the pathogenesis of hypertensive disorder complicating pregnancy and the levels of tHcy are decreased significa ntly using folic acid in combination with methylcobalamin in hypertensive disord er complicating pregnancy patients with hyperhomocysteinemia,which maybe helpful t o the progression of hypertensive disorder complicating pregnancy.