血浆同型半胱氨酸及叶酸、维生素B_(12)与深静脉血栓关系的病例对照研究

目的探讨同型半胱氨酸(homocysteine,Hcy)及叶酸、维生素B12与深静脉血栓(deep venous thrombosis,DVT)的关系。方法采用病例对照研究的方法,对50例确诊为DVT的患者及来自同一地区、性别、年龄匹配的50例对照,调查流行病学资料,同时检测血中Hcy、叶酸、维生素B12含量,分析其与DVT形成之间的关系。结果血浆高同型半胱氨酸(HHcy)水平、血中叶酸水平低下与DVT发生的关系有统计学意义,OR分别为3.74(1.21～11.59)、0.17(0.05～0.53)。血中叶酸水平与Hcy水平相关,偏相关系数为-0.21,P值为0.04;维生素B12水平与叶酸水平相关,偏相关系数为0.31,P值为0.002。结论血浆HHcy水平与DVT发生的危险性增高呈正相关;血中叶酸和维生素B12水平与DVT发生的危险性呈负相关;低叶酸水平不仅通过增加血Hcy水平,而且可能通过其他机制,增加DVT发生的危险性;血中维生素B12水平低下主要是通过影响叶酸水平,引起HHcy,进而增加DVT发生的危险性。

STUDY ON RELATIONSHIP BETWEEN HOMOCYSTEINE, FOLIC ACID, Vitamin B12 AND DEEP VENOUS THROMBOSIS

Objective To explore the relationship between plasma homocysteine(Hcy),folic acid,VB12 level and deep venous thrombosis(DVT).Method With case-control study design,fifty DVT patients were included in this study as case group,and 50 healthy subjects selected from the same area as control group.Epidemiological survey were made,and 4ml fasting venous blood was collected for all subjects.Radio-immunoassay and fluorescence polarization immunoassay(FPIA) were used to measure blood serum folic acid,VB12 and plasma Hcy levels respectively.The correlation between Hcy level and DVT was analyzed.Results Plasma Hcy level of subjects in case group was higher than that in control group,There was significant difference of HHcy and low serum folic acid between case and control,and the OR(95%CI) was 3.74(1.21-11.59)and 0.17(0.05-0.53) respectively.There existed correlation among Hcy level,folic acid and VB12 levels.Partial correlation analysis showed the same results between Hcy level and folic acid level,VB12 level and folic acid level,while there existed negative correlation between Hcy level and VB12 level.Conclusion HHcy and low blood folic acid level increased DVT risk.Low blood levels of folic acid and VB12 increase the risk of HHcy.