血浆同型半胱氨酸测定在心脑血管疾病诊断中的价值

目的 评价应用循环酶法测定血浆同型半胱氨酸（Hcy）在心脑血管疾病诊断中的应用价值.方法 选取脑卒中患者120例,分为缺血组60例和出血组60例 冠心病患者130例,分为稳定型心绞痛组40例,不稳定型心绞痛组35例,急性心肌梗死组55例 对照组50例,采用循环酶法测定Hcy值.结果 脑卒中缺血组和脑卒中出血组Hcy测定值和对照组测定值相比差异均有统计学意义（P〈0.01）,但脑卒中缺血组和脑卒中出血组之间差异没有统计学意义（P〉0.05）.冠心病稳定型心绞痛组、不稳定型心绞痛组和急性心肌梗死组Hcy测定值和对照组Hcy测定值相比差异均有统计学意义（P〈0.05） 稳定型心绞痛组、不稳定型心绞痛组和急性心肌梗死组Hcy测定值有逐渐升高趋势,三者Hcy测定值相比有统计学意义（P〈0.05）.结论 Hcy与心脑血管疾病的关系密切,有望成为检测疾病发生发展的指标之一.     

浅谈血清同型半胱氨酸水平在心脑血管疾病治疗中的临床价值

目的研究血清同型半胱氨酸水平在心脑血管疾病中的作用,寻找合适的治疗方法。方法主要通过对医院一年中收治的200例心脑血管疾病的患者进行病情跟踪和治疗记录,通过设置对照试验的方式进行考察。结果调查数据显示,患有心脑血管疾病的患者,其血液中的半胱氨酸水平比对照组要高,差异较明显。结论实验结果说明通过测定血同型半胱氨酸水平,可以判断心脑血管的健康与否,对于彻底治疗这类疾病具有重要的意义。     

探讨循环酶法测定同型半胱氨酸测定在临床上的应用

目的：探讨循环酶法（ Enzymaticcyclingassay）测定血清同型半胱氨酸水平的临床应用价值。方法氧化型HCY被转化成游离HCY游离HCY在CBS催化下和丝氨酸反应生成L-胱硫醚。 L-胱硫醚在CBL催化下又生成HCY、丙酮酸和NH3。该循环反应生成的丙酮酸可以用乳酸脱氢酶 LDH和NADH检测到，NADH转变生成NAD＋的速率与样品中的HCY含量正比。在全自动奥林巴斯上测得结果。结论同型半胱氨酸检测试剂盒用于人血清或血浆中同型半胱氨酸含量的测定，用于心血管疾病、糖尿病、肾病、中风、老年痴呆症及妊娠相关疾病的体外诊断。     

同型半胱氨酸与心脑血管疾病的相关性研究

目的探讨血清同型半胱氨酸(Hcy)与心脑血管疾病的关系。方法用化学发光法检测86例有明确诊断的心脑血管疾病患者血清Hcy的浓度,另外选择健康人群30例作为对照组同步测定血清Hcy浓度。结果心脑血管疾病患者Hcy的浓度显著高于正常对照组(P<0.01)。结论 Hcy检测有助于了解心脑血管疾病的发生和病情变化,另外Hcy作为独立的心脑血管疾病的危险因素对心脑血管疾病的预防和早期诊断有着积极的临床意义。     

血同型半胱氨酸与心脑血管疾病的研究

目的:本文主要为了研究血同型半胱氨酸与心脑血管疾病之间的关系.方法:在我院2015年12月-2017年5月收治的冠心病患者和脑梗死患者中分别选取100例作为研究对象,另外,选择同一时期在我院体检的健康体检者100例,三组分别称为心血管病组、脑血管病组和正常对照组,分别检测三组患者的血清同型半胱氨酸水平.结果:心血管病组患者的血同型半胱氨酸水平明显高于正常对照组,差异具有统计学意义(P<0.05);脑血管病组患者的同型半胱氨酸水平也高于正常对照组,差异有统计学意义(P<0.05),但是脑血管病组患者低于心血管病组患者.结论:血同型半胱氨酸的水平高低能够反应患者的心脑血管健康情况,所以,对心脑血管疾病高危人群定期进行血同型半胱氨酸水平的检测,具有非常重要的临床价值.     

同型半胱氨酸与心脑血管疾病的关系

同型半胱氨酸(HCY)是一种含硫氨基酸,Hcy来源于饮食摄取的蛋氨酸,在体内含量极微,Hcy和甲基四氢叶酸在蛋氨酸合成酶的作用下,生成蛋氨酸和四氢叶酸,四氢叶酸在N5N10亚甲基四氢叶酸还原酶的作用下生成甲基四氢叶酸,近年来Hcy与心脑血管疾病关系引起人们的重视,现研究发现Hcy可以直接或间接导致血管内皮细胞损伤,促进血管平滑肌细胞增值,影响低密度脂蛋白的氧化,增强血小板功能促进血栓形成。越来越多的资料表明,Hcy是心脑血管疾病的一个独立危险因素[1]。1测定方法及正常参考值同型半胱氨酸的参考值随测定方法和所选择的人群不同而有一些…     

血液同型半胱氨酸经循环酶法的测定及临床应用价值

目的：探讨循环酶法测定血液同型半胱氨酸（HCY）的方法及其临床应用价值。方法：通过循环酶法测定HCY的精密度及重复性，并对68例健康体检者和53例住院患者（13例冠心病、20例高血压、20例脑梗死）血液中HCY进行测定。结果：循环酶法测定HCY的批内平均变异系数为2．23％，批间平均变异系数为1．59％。68例正常人中，t=6．905〉1．94，P〉0．05；53例住院患者中，冠心病组HCY含量明显高于正常组（P〈0．01），高血压组HCY高于正常组（P〈0．01），脑梗死组HCY明显高于正常组（P〈0．01）。结论：循环酶法测定血液HCY操作简单快捷，具有较好的精密度、准确性和重复性，适合临床实验室常规使用。     

同型半胱氨酸循环酶法自动分析仪测定的临床应用研究

目的探讨同型半胱氨酸循环酶法自动分析仪测定的临床应用。方法应用同型半胱氨酸循环酶法自动分析仪测定高血压患者118例,脑梗死患者78例以及健康人群89例,分析比较3组的检测结果。结果通过对同型半胱氨酸浓度高、中、低3个血清样本进行检测,发现高值样本(32.48±3.67)μmol,CV1.6%;中值样本(19.88±2.97)μmol,CV1.8%;低值样本(7.56±1.13)μmol,CV1.6%;3种样本混合后检测15次,平均值为(22.23±2.38)μmol,CV4.2%。取2个较已测值(原值)高的血清作为加入物,加到已测值的混合血清中,然后进行测定并计算回收率,结果 94.8%~108.7%,平均102.3%。3组人群血清同型半胱氨酸分别为(7.92±1.56)μmol、(11.72±5.21)μmol、(14.36±5.78)μmol,3组相比较差异有统计学意义,P﹤0.05;脑梗死组与高血压组相比,P﹤0.05;3组血清同型半胱氨酸阳性率相比,差异有统计学意义,P﹤0.05。结论该方法简便、重复性好,适合全自动生化分析仪常规检测,Hcy水平的检测对脑血管疾病危险性的监测是1个敏感指标,对脑梗死的预后诊断具有实际应用价值。     

小儿特发性癫痫血清同型半胱氨酸水平测定的临床意义

目的探讨小儿特发性癫痫与高同型半胱氨酸血症的关系。方法对特发性癫痫患儿与健康对照组儿童采用循环酶法检测血清同型半胱氨酸（Hcy）含量。分析癫痫组和对照组Hdy水平与不同癫痫类型间Hcy的差异。结果110例特发性癫痫患儿血清同型半胱氨酸水平为16．07μmol／L，40例对照组血清同型半胱氨酸水平为7．20μmol／L，2组比较差异有统计学意义。结论小儿特发性癫痫与高同型半胱氨酸血症有关。     

同型半胱氨酸与心脑血管疾病高危因素的孟德尔随机化研究

目的 采用孟德尔随机化方法,探讨同型半胱氨酸(Hcy)含量与心脑血管疾病高危因素间的潜在因果关联.方法 基于常州市武进区自然人群队列的2611个研究样本,采用全基因组芯片进行基因分型,选取全基因组关联研究确定的18个Hcy含量相关的单核苷酸多态性位点(Single Nucleotide Polymorphisms,SNPs)作为工具变量,构建Hcy的加权遗传评分(wGRS),分析Hcy相关wGRS与血压、空腹血糖、血脂等高危因素的关系.结果 孟德尔随机化研究结果显示,未发现Hcy相关wGRS与血压、血脂存在显著关联.在不饮酒者中,wGRS与血糖水平表现为正性统计学关联(β=0.33,95％ CI:0.03～0.63,P＜0.05);在饮酒者中,wGRS与血糖水平表现为负性统计学关联(β=-0.28,95％CI:-0.55～0.00,P＜0.05).结论 Hcy相关wGRS与血压、血脂无统计学关联,但对血糖的影响在不同饮酒状态者中的效应存在差别.     

冠心病患者检测同型半胱氨酸的临床意义

目的 探讨冠心病(coronary heart disease,CHD)患者检测血清同型半胱氨酸(homocysteine,HCY)的临床意义.方法 将84例CHD患者作为实验组,并将其分为三个亚组,健康人群60例为对照组,测定血清HCY的含量.结果 CHD组HCY的含量显著高于对照组(P<0.05),CHD患者各亚组间HCY含量比较,差异有统计学意义(P<0.05).结论 HCY与CHD具有相关性,对CHD诊断和治疗有重要的临床意义.     

2型糖尿病患者血清直接胆红素水平与心血管疾病的相关性

目的 探讨2型糖尿病患者血清直接胆红素(D-Bil)水平与心血管疾病(CVD)的相关性.方法 回顾性分析280例2型糖尿病住院患者的临床资料,按照有无CVD分为糖尿病合并CVD组与糖尿病非CVD组,比较两组年龄、性别、可追溯糖尿病病程、吸烟、体质指数(BMI)、D-Bil、糖化血红蛋白(HbA1C、血脂、血压,应用Logistic回归分析D-BiJ与CVD的相关性.结果 糖尿病合并CVD组年龄、可追溯糖尿病病程、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、低密度脂蛋白(LDL)高于非CVD组,D-Bil低于非CVD组(P<0.05);在调整了年龄、可追溯糖尿病病程、SBP、DBP、HbA1C、TC、LDL后,D-Bil与CVD呈负相关(OR=0.854,95%CI:0.737-0.990).结论 2型糖尿病患者D-Bil的降低可能是糖尿病合并CVD的独立危险因素之一.     

Prospective Studies of Homocysteine and Cardiovascular Disease

The link between vascular disease and elevated homocysteine levels has been recognized for more than 30 years, and an association with moderately elevated levels has been suspected for 20 years. The initial investigations were case series, cross-sectional, and case-control studies. Those studies consistently suggest a strong positive relationship between moderate hyperhomocysteinemia and risk of vascular disease. However, a major limitation of these types of study design is that the possibility of elevated homocysteine levels being influenced by the disease or its treatment cannot be ruled out. In case-control studies there is always concern about the appropriateness of the control group. These issues pose much less of a problem in prospective designs. Prospective studies also offer the opportunity to study various manifestations of cardiovascular disease at the same time. However, prospective studies tend to be more expensive and time-consuming, perhaps explaining the smaller number of prospective studies and why the first was not published until 1992. The distinct limitations and advantages of prospective studies are also reviewed.     

Homocysteine,Iron and Cardiovascular Disease: A Hypothesis

Elevated circulating total homocysteine (tHcy) concentrations (hyperhomocysteinemia) have been regarded as an independent risk factor for cardiovascular disease (CVD). However, several large clinical trials to correct hyperhomocysteinemia using B-vitamin supplements (particularly folic acid) have largely failed to reduce the risk of CVD. There is no doubt that a large segment of patients with CVD have hyperhomocysteinemia; therefore, it is reasonable to postulate that circulating tHcy concentrations are in part a surrogate marker for another, yet-to-be-identified risk factor(s) for CVD. We found that iron catalyzes the formation of Hcy from methionine, S-adenosylhomocysteine and cystathionine. Based on these findings, we propose that an elevated amount of non-protein-bound iron (free Fe) increases circulating tHcy. Free Fe catalyzes the formation of oxygen free radicals, and oxidized low-density lipoprotein is a well-established risk factor for vascular damage. In this review, we discuss our findings on iron-catalyzed formation of Hcy from thioethers as well as recent findings by other investigators on this issue. Collectively, these support our hypothesis that circulating tHcy is in part a surrogate marker for free Fe, which is one of the independent risk factors for CVD.     

叶酸及同型半胱氨酸与心血管疾病研究进展

同型半胱氨酸(Hcy)是心血管疾病的一种新的独立危险因素,补充叶酸等B族维生素是最经济有效的降低血浆Hcy水平的方法,B族维生素的补充与强化还没有一个明确的参考剂量与组合方案。Hcy也可能是叶酸缺乏的伴随表现,叶酸缺乏才是心血管疾病的根本原因。补充叶酸是降低心血管疾病的发病率还是死亡率还不明确。     

Serum Folate and Homocysteine Levels Are Associated With Colon Tumorigenesis in End-Stage Renal Disease Patients

The aim of this study was to evaluate the effect of folate and homocysteine on colon tumorigenesis by performing colonoscopy and examining serum folate and homocysteine levels in end-stage renal disease (ESRD) patients. We performed colonoscopy in 72 ESRD patients who were undergoing hemodialysis and also measured their serum folate and homocysteine levels. Serum folate and homocysteine concentrations of the 72 ESRD patients were 6.0 ± 3.9 μg/l and 37.3 ± 25.5 μmol/l, respectively. Colorectal neoplasia was detected in 47 (65%) of the patients. Compared to a control group, ESRD patients had significantly more and larger neoplasia (P = 0.002 and 0.001, respectively). Multivariate analysis revealed that ESRD patients with lower levels of serum homocysteine had significantly more and larger neoplasia than those with higher levels (P = 0.02 and 0.03, respectively). In addition, patients with a shorter duration of hemodialysis were likely to have larger neoplasia. ESRD patients had higher than normal serum homocysteine levels. Interestingly, patients with lower homocysteine levels were likely to carry more and larger colorectal neoplasia. These results suggest that suppression of folate metabolism and an elevated serum homocysteine concentration are inversely associated with colon tumorigenesis in ESRD patients.     

Serum Homocysteine Concentration of US Adults Associated with Fortified Cereal Consumption

Background: Elevated serum total homocysteine (tHcy) concentration is implicated in the etiology of cardiovascular disease (CVD). A significant food source of B-vitamins involved in homocysteine metabolism is ready-to-eat cereal (RTEC) in the U.S.

Objective: To test the hypothesis that tHcy concentration is inversely associated with RTEC intake and blood B-vitamin levels in the U.S. general population.

Design: A cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES 1999–2000). Data were stratified according to age and gender. Men and women ≥ 19 y (n = 4,218) were classified as RTEC consumers (RTEC-C; n = 824) and RTEC non-consumers (RTEC-NC; n = 3,394) based on 24-hr dietary recall.

Results: Forty nine percent of participants showed folate intake with below the estimated average requirements (EARS). Serum folate and red blood cell (RBC) folate concentrations were increased with age in both genders, and significantly higher among RTEC-C than RTEC-NC (p < 0.05). Mean tHcy concentration increased with age, and was significantly lower among both men and women RTEC-C than among RTEC-NC. In multivariate linear regression analyses, RTEC consumption strongly predicted serum folate and tHcy concentrations.

Conclusion: tHcy concentrations were significantly lower in RTEC-C among the majority of age/gender groups than in RTEC-NC. RTEC consumption may potentially reduce the risk for CVD, mediated through tHcy.     

冠心病患者胆红素浓度变化对机体脂质过氧化水平的影响及黄芪的干预作用

目的探讨冠心病患者血清胆红素浓度变化对机体脂质过氧化水平的不良影响并观察黄芪的干预效果。方法选取 45例冠心病病人和 40例正常人作为研究对象 ,抽空腹静脉血检测血清胆红素、总抗氧化能力 (T- AOC)、丙二醛(MDA)及血浆氧化修饰低密度脂蛋白 (Ox- L DL )浓度 ,并给冠心病患者每人每天静滴黄芪注射液 6 0 ml,连用 1周 ,复测上述指标。结果与对照组相比 ,冠心病患者血清胆红素浓度及 T- AOC明显降低 (P均 <0 .0 1) ,而 MDA及 Ox- L DL则明显升高 (P均 <0 .0 1) ,且血清总胆红素浓度与 T- AOC呈显著正相关 (r=0 .36 8,P<0 .0 1) ,而与 MDA及 Ox- L DL 则呈显著负相关 (r=- 0 .30 1及 - 0 .34 2 ,P<0 .0 5及 0 .0 1)。干预结果显示 ,黄芪可以显著升高冠心病患者 T- AOC并降低MDA和 Ox- L DL 水平 (P均 <0 .0 1)。结论冠心病患者血清胆红素浓度明显降低 ,并由此导致机体抗氧化能力下降和脂质过氧化水平升高 ,但这一变化可以应用黄芪有效纠正