溃疡性结肠炎患者血清同型半胱氨酸的检测及其临床意义

Detection and clinical significance of serum homocysteine in ulcerative colitis

目的探讨同型半胱氨酸（homocysteine，Hcy）水平与溃疡性结肠炎（ulcerative colitis，UC）及UC患者血清中抗中性粒细胞胞质抗体（antineutrophil cytoplasmic antibody，ANCA）的关系。方法采用直接化学发光法检测60例UC患者和20例正常对照者血清Hcy浓度；应用间接免疫荧光法检测60例UC患者血清中ANCA滴度。结果UC患者组的血清Hcy水平为（14．69±6．77）μmol／L，显著高于正常对照组（11．16±2．67）μmol／L，差异有统计学意义（P〈0．01）；UC患者轻、中、重度组间血清Hcy水平差异均无统计学意义（P均〉0．05）；直肠、乙状结肠组血清Hcy水平分别与左半结肠组、全结肠直肠组比较差异均有统计学意义（P均〈0．01）。UC患者中高Hey和低Hcy两组间ANCA阳性率比较，差异有统计学意义（P〈0．05）。结论血清Hcy水平升高在UC患者中具有一定普遍性，其与UC患者病程无关，只与病变范围有关。血清Hcy水平有助于预测UC患者ANCA检测结果，为临床提供诊断依据。

Objective To investigate the associations among ulcerative colitis （UC）, antineutrophil cytoplasmic antibody （ANCA） and serum homocysteine （Hcy） levels. Methods Serum Hcy in 60 cases of UC patients and 20 controls were detected by direct chemilu-minescence method. ANCA titer in 60 cases of UC patients were detected by indirect immunofuo-rescence assay. Results The levels of serum Hcy in UC patients [ （14.69±6.77） μmol/L] was higher than that in controls [ （11.16±2.67） μmol/L], and the difference had statistical significance （P〈 0.01 ）. Serum Hcy levels in UC patients with mild, moderate and severe groups had no significant difference （P〉 0.05 ）. The level of serum Hcy in rectum and sigmoid group was higher than in left colon and full colorectal groups, the differences all had statistical significance （Pall〈 0.01 ）. There was a difference of ANCA-positive rate between high and low levels of Hcy groups in UC patients （P〈 0.05）. Conclusion Elevated serum Hcy level can be seen generally in UC patients, it has nothing to do with disease index of UC, only was correlated with the position of lesion. Test results of serum Hcy level in UC patients help to calculating their ANCA test results, and offer diagnostic basic to clinical.