巨幼细胞性贫血患者同型半胱氨酸检测的意义

Significance of Homocysteine Examination in Megaloblastic Anemia Patients

目的 检测巨幼细胞性贫血患者同型半胱氨酸水平 ,证实在叶酸、维生素B12 缺乏性疾病时同型半胱氨酸水平是否升高 ?单纯升高的同型半胱氨酸是否造成冠状动脉硬化 ?方法 同型半胱氨酸水平检测用酶免疫分析法 ,叶酸、维生素B12 检测用放射免疫分析法 ,肌红蛋白、肌钙蛋白用胶体金法 ,CK MB用免疫抑制法 ,TC用酶法比色法 ,LDL用免疫透射比浊法。结果 巨幼细胞性贫血患者同型半胱氨酸水平 (2 3.4± 7.80 μmol/L)比对照组 (13.5 0± 3.0 0 μmol/L)和其他贫血组 (12 .80±2 5 0 μmol/L)明显升高 (P <0 .0 1)。 结论 巨幼细胞性贫血患者同型半胱氨酸水平明显升高 ,但单纯同型半胱氨酸水平明显升高的 18例患者无一例导致冠状动脉硬化 ,同时合并有高TC、LDL的 3例患者中 2例出现心肌损害 ,高同型半胱氨酸导致的冠状动脉硬化是一个多因素过程 ,其中有高TC、LDL参与。

Aims To see if homocysteine increases in megaloblastic anemia patients and if increase of homocysteine will incur coronary sclerosis. Methods Homocysteine was analysed by enzymic immunoassay; folacin and vitamin B 12 were analysed by radioimmunoassay; myoglobin and troponin by collidal gold method; CK-MB by immunosuppression method ;TC by enzymic colorimetry; and LDL by immune transmission-turbidimetry.Results The megaloblastic anemia patients was higher in the homocysteine than normal control or anemia patients of other types (P<0.01).18 patients with increase of homocysteine but without increase of TC and LDL were free of coronary sclerosis, but 2 of 3 patients with both increase of homocysteine and increase of TC and LDL were found with coronary sclerosis.Conclusion Serum homocysteine increases in megaloblastic anemia patients, but occur of coronary sclerosis induced by homodysteine is a multiple-factor process, involving the participation of TC and LDL.