酒精性肝病患者同型半胱氨酸与叶酸水平观察

Investigation on plasma homocysteine and folate levels in alcoholic liver disease

目的探讨酒精性肝病(ALD)患者血浆同型半胱氨酸(Hcy)与叶酸浓度变化及二者与ALD的关系。方法选择轻型酒精性肝病60例,酒精性脂肪肝64例,酒精性肝炎42例,酒精性肝硬化40例,健康人群55例,并测定血浆中Hcy和叶酸含量。结果各酒精性肝病组Hcy和叶酸水平均高于对照组(P<0.05);各酒精性肝病组治疗后Hcy和叶酸水平均低于治疗前(P<0.05);酒精性肝硬化组治疗后Hcy和叶酸水平高于对照组(P<0.05);对照组,轻型酒精性肝病组,酒精性脂肪肝组和酒精性肝炎组Hcy和叶酸存在相关性(r=0.513,P<0.001;r=0.513,P<0.001;r=0.513,P<0.001;r=0.513,P<0.001),但酒精性肝硬化组二者间无相关性(r=0.201,P>0.05)。结论酒精性肝病Hcy和叶酸水平变化可反映肝功能损害程度,对ALD的治疗与预后判断有一定临床意义。

Objective To investigate the change of plasma homocysteine（Hcy） and folate levels in alcoholic liver disease（ALD） and their relation with ALD.Methods Plasma Hcy and folate in 60 mild alcoholic liver disease patients,64 alcoholic fatty liver patients,42 alcoholic hepatitis patients,40 alcoholic cirrhosis patients and 55 healthy controls were measured by 7170 automatic biochemical analyzer and Bayer ACS180.Results The levels of plasma Hcy and folate in four groups of ALD patients were significantly higher than those in the healthy controls（P0.05,P0.05,P0.05,P0.05）.The levels of Hcy and folate in alcoholic cirrhosis patients after treatment were significantly higher than those in the healthy controls（P0.05）.There was significantly positive correlation between Hcy and folate（r=0.421,P0.001;r=0.612,P0.001;r=0.552,P0.001;r=0.513,P0.001）in healthy controls,mild alcoholic liver disease group,alcoholic fatty liver group and alcoholic hepatitis group.But,there was no correlation between Hcy and folate（r=0.201,P0.05） in alcoholic cirrhosis group.Conclusion The plasma Hcy and folate levels can reflect the degree of liver damage and have some clinical significance on the treatment and prognosis of ALD.