慢性肾功能衰竭患者的高同型半胱氨酸血症及临床意义

目的 探讨慢性肾功能衰竭（chronic renal failure,CRF）患者同型半胱氨酸（homocysteine,Hcy）血浆水平变化及临床意义.方法 采用酶循环速率法对88例CRF患者和25例正常对照人群的Hcy血浆浓度的检测并进行比较分析.结果 CRF患者Hcy血浆浓度明显高于对照组（P＜0.05）,随着慢性肾功能衰竭的加重,Hcy血浆浓度也相应的升高.CRF患者血浆Hcy浓度与血肌酐水平呈正相关（P＜0.001）,与肌酐清除率水平（P＜0.001）呈负相关,而与叶酸、维生素B12等生化指标均无明显相关.CRF患者血浆叶酸、维生素B12水平与对照组无明显差异.结论 CRF患者普遍存在高Hcy血症,其水平与血肌酐水平呈正相关,可能与肾小球滤过率降低、对同型半胱氨酸清除减少有关,检测血浆Hcy浓度对了解CRF患者病情具有重要意义.

High homocysteinemia and its clinical significance in chronic renal failure patients

Objective To evaluated plasma homocystein value change and its clinical significance in chronic renal failure （CRF）. Methods 88 CRF patients and 25 normal controls were enrolled, and their plasma homocystein were examined using Enzymatic Cycling Assay method, the data of all of the CRF patients and normal controls were compared and analyzed. Results CRF patients have significant high level of plasma homocystein than those of normal controls （P〈 0.05）, With the progress of CRF, patient＇s plasma homocystein value increases. CRFpatients＇ plasma homocystein were in positive cor- relation （P〈0.001） with serum creatinine （Scr）, and in negative correlation （P〈0.001） with creatinine clearance （Ccr）, but in no correlation with other biochemical parameters （e. g. folicacidandVitB12）. There were no significant differences in plasma folic acid, and VitB12 levels between CRF patients and normal controls. Condusion CRF patients commonly have high plasma homocystein value. It possibly related to the decrease of glomerular filtration rate and reduction of homocystein removal by kidney. Hence, to exam the plasma homocystein has important significance to evaluate the conditions of CRF patients.