妊娠高血压综合征患者血浆总同型半胱氨酸水平检测的临床研究

Clinical evaluation of measuring plasma total homocysteine in patients with pregnancy induced hypertension

目的 探讨妊娠高血压综合征(妊高征)患者血浆总同型半胱氨酸(tHcy)水平检测的临床意义。方法 采用美国雅培公司生产的IMX全自动快速免疫分析仪中的荧光偏振免疫分析法检测血浆tHcy水平。同步取静脉血检测血清叶酸、维生素B12的浓度。病例选自产科收治的妊高征患者162例,对照组为150例年龄匹配的正常晚期妊娠妇女。结果 (1)妊高征组与对照组比较,血浆tHcy水平差异有非常显著意义;血清叶酸浓度差异无显著意义;血清维生素B12的浓度差异无显著意义。(2)妊高征组中,轻度、中度、重度患者tHcy水平,重度患者明显高于中度患者,中度患者明显高于轻度患者。(3)34 例重度患者,随机分为三组,给予口服叶酸:第1组(10例)5 mg,qd;第2组(12例)5 mg,tid;第3组(12例)10 mg,tid,疗程均为10 d,治疗前后血浆tHcy水平比较,第1组差异无显著意义;第2 组差异有非常显著意义;第3 组差异有非常显著意义。治疗后第2、3组血浆tHcy水平比较差异无显著意义。结论 妊高征患者血浆tHcy水平明显升高,且随着病情的加重,血浆tHcy水平呈逐渐上升趋势,监测血浆tHcy水平对了解妊高征病情具有重要意义;一定剂量的叶酸可显著降低重度妊高征患者的血浆tHcy水平,减少高Hcy对血管的毒性作用,有助于改善妊高征患者的疾病转归。

Objective To evaluate the clinical significance of the level of plasma total homocysteine(tHcy) in patients with pregnancy induced hypertension(PIH).Methods The level of plasma tHcy were detected by fluorescence polarization immunoassay(FPIA) in 162 patients with PIH.Concentrations of serum folic acid and VitB_(12) were measured at the same time.150 cases of normal late pregnancy in the same age were selected as control group.Results (1)The level of plasma tHcy was significantly higher in PIH group than that in control group;both the level of serum folic acid and the level of serum B_(12) were not statistically significant between two groups.(2)In PIH group,the level of plasma tHcy was significantly higher in severity than that in secondary,the level of plasma tHcy was significantly higher in secondary than that in lightness.(3)34 severities were randomly divided into the first group(n=10,folic acid 5mg,po,qd),the second group(n=12,folic acid 5mg,po,tid),the third group(n=12,folic acid 10mg,po,tid),total for 10d.In the first group,the level of plasma tHcy was not statistically significant before and after treatment.In the second and third group,the level of plasma tHcy were significantly lower after treatment than that before treatment.After treatment,the level of plasma tHcy was not statistically significant between the second and third group.Conclusions The level of plasma tHcy significantly elevated in patients with PIH.In PIH group,there is a trend that the level of plasma tHcy increased with severity of PIH.Measuring the level of plasma tHcy is of great value to know the degree of the PIH.Folic acid can significantly reduce the level of plasma tHcy in patients with severe PIH,and maybe help to the progression of PIH.