结肠腺瘤性息肉患者血浆同型半胱氨酸、叶酸、维生素B12水平观察

Plasma homocysteine, folic acid and vitamin B12 levels in patients with colon adenomatous polyps

选择我院消化内科诊断明确的结肠腺瘤性息肉患者120例（病例组）和同期正常健康体检者40例（对照组），测定其血浆同型半胱氨酸（Hcy）、叶酸、维生素B12水平。结果显示，病例组的血浆Hcy水平高于对照组[（14．24±0．52）μmol／L与（10．93±0．81）μmol／L，P=0．0014]，血浆叶酸水平低于对照组[（6．26±0．27）μg/L与（10．74±0．85）μg/L，P〈0．0001]，而两组维生素B12水平比较差异无统计学意义（P=0．7100）。结肠多发息肉者Hey水平高于单发组，叶酸水平低于单发组（P=0．0092，P=0．0047）。随着病理类型加重，患者Hcy浓度逐渐升高，而叶酸水平逐渐下降。不同个例最大息肉所在部位及息肉分布患者血浆FA、Hcy和VitB12水平差异无统计学意义。提示结肠腺瘤性息肉患者存在血浆Hcy水平和FA水平改变，其间可能存在密切联系。

Plasma levels of homocysteine （ Hcy）, folic acid （FA） and Vitamin B12 （ VB,2 ） were measured in 120 patients of colon adenomatous polyps and 40 healthy subjects. Plasma Hcy levels in colon adenomatous polyps patients were significantly higher than those in controls [ （ 14.24 ＋ 0.52） μmol/L vs. （10.93 ± 0. 81 ） ~mol/L,P = 0. 0014） ] , while plasma FA levels in polyps patients were lower than those in controls [ （6. 26 ±0. 27 ） μg/L vs. （ 10. 74 ± 0. 85） μg/L, P 〈 0. 0001] There was no difference in plasma VB12 levels between two groups（ P = 0. 7100）. The plasma Hcy levels in patients with multiple colon polyps were higher than those with single colon polyps （ P = 0. 0092 ） , while the plasma FA levels demonstrated contrary results （ P = 0. 0047 ）. With the pathological type progression, the plasma Hcy levels were gradually raised, and FA levels gradually decreased. Plasma levels of FA, Hcy and VB12 were not correlated with the location and distribution of polyps. These results suggest that plasma FA and Hcy levels may be related to disease progress in patients with colon adenomatous polyps.