血浆同型半胱氨酸水平与酒精性肝硬化关系的初步探讨

Relationship between plasma homocysteine and alcoholic liver cirrhosis

目的:观察血浆同型半胱氨酸(Hcy)水平对酒精性肝硬化的影响。方法:选择酒精性肝硬化12例、肝炎后肝硬化51例、混合性肝硬化21例及健康人群40例,测定血浆Hcy、叶酸、维生素B12(VitB12)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(T-Bil)、总胆汁酸(TBA)、白蛋白(Alb)的水平。结果:酒精性肝硬化患者血浆同型半胱氨酸水平明显升高(P<0.01),酒精性肝硬化患者较肝炎后肝硬化患者明显升高(P<0.05);同型半胱氨酸水平与酒精性肝硬化患者Child-Pugh得分呈负相关(r=-0.602,P<0.05)。结论:肝硬化患者血浆Hcy水平较正常人是升高的,且其在酒精性肝硬化患者升高更为显著。酒精性肝硬化患者随着肝脏损伤程度的逐渐增加,血浆Hcy水平是降低的。

Objective To observe the relationship of plasma homocysteine（Hcy） levels and alcoholic liver cirrhosis. Method Plasma levels of Hcy, folate, vitB12, alanine aminotransferase, gamma glutamyl transpepfidase, alkaline phosphatase, total bilirubin, total bile acid and albumin of liver cirrhosis were measured in 12 alcoholic liver cirrhosis, 51 posthepatitic cirrhosis and 21 mixed liver cirrhosis. Results Hcy levels were significantly higher in alcoholic cirrhoties（ P〈0.01 ） than that in control group and posthepatitic cirrhotics group, were inversely correlated with the severity of the liver disease measured by the Child-Pugh score in alcoholic cirrhoties. Conclusions Hcy levels were higher in cirrhotics than that in control goup, especially in alcoholic cirrhotics. However, with the increasing aggravation of liver impairment, Hcy levels could decreased in alcoholic cirrhotics.