补充多种维生素对血浆同型半胱氨酸水平的影响

The influence of multivitamin supplement on the plasma homocysteine level

目的通过我院干部体检资料的分析 ,探讨补充多种维生素 (多 Vit)对血浆同型半胱氨酸 (Hcy)水平的影响。方法对 1999年度我院干部体检中的正常组 5 89例和 1999年 4月～ 2 0 0 0年 10月间住院中的冠心病组 179例 ,用酶联免疫法测定血浆 Hcy浓度 ,电化学发光法测定血清叶酸、Vit B1 2 水平 ,同时调查其是否服用含叶酸的多Vit。结果 1.正常组 :(1)服多 Vit组 ,血清叶酸水平明显高于未服组 ,而血浆 Hcy水平明显低于未服组 ,血清Vit B1 2 水平两组间无明显差异。 (2 )服用多 Vit组 ,血浆 Hcy水平≥ 15 μmol/ L 者的比例明显低于未服用多 Vit组。2 .冠心病组 :(1) Hcy水平明显高于正常组 ,叶酸水平明显低于正常组 ,Vit B1 2 水平两组间无明显差异。 (2 )血浆 Hcy水平 ,急性心肌梗死组和心绞痛组明显高于陈旧性心肌梗死组。(3)除心绞痛组 ,服用多 Vit者叶酸水平明显高于未服用者外 ,冠心病其余二组服用多 Vit者 Hcy、叶酸、Vit B1 2 水平均无显著差异。结论服用含叶酸的多 Vit对血浆Hcy水平有明显影响。服用多 Vit可提高血清叶酸水平 ,使正常组血浆 Hcy水平降低 ,减少冠心病的患病率 ,但对已患有冠心病者补充多 Vit对血浆

Objective To investigate the influence of multivitamin supplement on the plasma homocysteine (Hcy) level. Methods 589 normal cases selected from annual health check group and 179 patients with coronary artery disease were interrogated whether taking multivitamin or not. Plasma Hcy concentration was measured using enzyme immunoassay and serum folate, VitB 12 concentration were measured using electro chemilumineseence immunoassay. Results 1 Normal group: (1) Serum folate levels of taking multivitamin group (188 cases) was higher than the nontaking multivitamin group (401 cases). Plasma Hcy levels of taking multivitamin group was lower than the nontaking multivitamin group. The difference was not significant in serum VitB 12 concentration between the two groups. (2) If Hcy >15 μmol/L is considered as risk index, the percentage of case in the taking multivitamin group is significantly lower than the nontaking multivitamin group. 2 Coronary artery disease group: (1) Plasma Hcy levels in disease group was higher than normal group; serum folate levels was lower in disease group than in normal group, the different was not significant in serum VitB 12 concentration between two groups. (2) Plasma Hcy levels in AMI group and in angina pectoris group were higher than in OMI group; the different was not significant in serum folate and VitB 12 levels in all groups. (3) Except that serum folate level was higher in taking multivitamin patients than nontaking multivitamin patients in angina pectoris group, the different was not significant in plasma Hcy levels and serum folate and VitB 12 levels in all groups. Conclusion Daily taking multivitamin (containing folate) can raise the serum folate concentration and prevent hyperhomocysteinemia in normal individuals, prevalence rate in coronary artery disease may be reduced. However multivitamin supplement has no significant influence on the plasma concentration of homocysteine in patients with coronary artery diseases.