深圳地区营养性巨幼细胞性贫血与同型半胱氨酸水平的相关性研究

Correlation between Nutritional Megaloblastic Anemia and Homocysteine in Shenzhen

目的探讨血清同型半胱氨酸（homocysteine，Hcy）水平与营养性巨幼细胞性贫血（megaloblastic anemia，MA）之间的关系，评价检测Hcy在MA诊断治疗、预后及监测等方面的应用。方法检测实验组（192例营养性MA患者其中包括单纯叶酸缺乏贫血患者69例、单纯维生素B12缺乏贫血患者60例，同时缺乏叶酸和单纯维生素B12缺乏贫血患者63例）、对照组（200例来自深圳市福田区人民医院体检且体检结果正常的健康人）和治愈组（已治愈实验组的192例单纯营养性MA患者）叶酸、维生素B12、Hcy水平。结果实验组与对照组做比较，血清中的叶酸、维生素B12，Hey水平比较差异均有统计学意义（t=3．56，3．21，2．78，P〈0．01）；对照组与治愈组做比较，血清中的叶酸、维生素B12，Hey水平比较差异无统计学意义（t=1．23，0．98，0．77，P〉0．05）；营养性MA患者不同缺乏物质各组间Hey水平差异无统计学意义（t=1．42，P〉0．05）。结论营养性MA患者血清中的Hey水平高于健康人血清中的Hcy水平，高水平Hcy与营养性MA存在相关性，可通过监测血清中Hcy的水平变化指导营养性MA的治疗。

Objective To discuss the correlation between nutritional megaloblastic anemia and homocysteine,in order that evaluate the application of homocysteine in some aspects that detection and treatment of megaloblatic anemia. Methods The study was divided into three groups,included case group （MA group, n= 192,including megaloblatic anemia of vitamin B12 deficiency, n = 60 ; megaloblatic anemia of folic acid deficiency, n = 69 ; megaloblatic anemia of folic acid and vitamin B12 deficiency, n = 63）, matched group （heathy persons, n = 200） and treated group （persons who recovered from megaloblatic anemia,n= 192）. Results The difference on homolevel in plasma between ease group and matched group had statistical sidnificanoe （t= 3.56,3.21,2.78, P〈0.01 ）. The difference on homocysteine level in plasma between treated group and matched group had no statistical sidnificance （t=1.23,0.98,0.77 ,P〉0. 05）. The Hey levels of folic acid deficiency vitamin B12 deficiency,vitamin B12 deficiency and folic acid and vitamin B12 deficiency had no statistical sidnificance （t= 1.42, P〉0.05）. Conclusion The homocysteine level of patients who had nutritional megalohlatic anemia higher than heathy persons. High level of homocysteine had correction between the nutritional megaloblatic anemia. The lack of some nutrition facters （eg：folie acid,vitamin B12） can lead to high homocysteine disease. Detecting the change of homocysteine level in plasma can guide the treatment of nutritional megaloblatic anemia.