目的 探討缺血性腦血管病患者高同型半胱氨酸(Hcy)血癥與顱內外動脈狹窄的關系。 方法 2007年6月-2009年12月收治缺血性腦血管病患者90例，根據全腦血管造影檢查結果分為顱內外動脈狹窄組和顱內外動脈無狹窄組；顱內外動脈狹窄組依狹窄部位分為單純顱內動脈狹窄組、單純顱外動脈狹窄組及顱內外動脈均有狹窄組；分析各組同型半胱氨酸的水平。 結果 顱內外動脈狹窄組血漿Hcy水平顯著高于顱內外動脈無狹窄組(Plt;0.05)；單純顱內動脈狹窄組、單純顱外動脈狹窄組及顱內外動脈均有狹窄組血漿Hcy水平均顯著高于顱內外動脈無狹窄組(Plt;0.05)。 結論 高同型半胱氨酸血癥是顱內外動脈狹窄的危險因素，是單純顱內動脈狹窄及單純顱外動脈狹窄的共同危險因素。
目的 研究同型半胱氨酸轉硫途徑、維生素B6及內源性硫化氫在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。 方法 2010年2月－4月間篩選AECOPD患者16例和健康志愿者（對照組）13例，測定AECOPD患者加重期、緩解期及對照組的肺功能、血清硫化氫（H2S）、丙二醛（MDA）、葉酸、維生素B12、C反應蛋白、白介素6、血漿同型半胱氨酸、胱硫醚、半胱氨酸和維生素B6的濃度。計算半胱氨酸轉化率（半胱氨酸濃度/胱硫醚濃度）與胱硫醚轉化率（胱硫醚濃度/同型半胱氨酸濃度）參與分析。 結果 ① 加重期血清MDA水平[（7.3 ± 5.1）nmol/L ]比緩解期[（3.0 ± 1.4）nmol/L ]和對照組[（3.0 ± 2.2）nmol/L ]均升高（P＜0.01）；血清MDA水平與第1秒用力呼氣容積/用力肺活量（FEV1/FVC）、第1秒用力呼氣容積占預計值百分比（FEV1%預計值）呈負相關。② 加重期血清H2S水平與血漿維生素B6水平較緩解期與對照組降低（P＜0.01）；緩解期血清H2S水平[（47.2 ±5.1） μmol/L ]高于對照組[（38.8 ± 2.1） μmol/L ]，P＜0.01；血清H2S水平、血漿維生素B6水平均與FEV1%預計值呈正相關（r=0.651、0.680，P＜0.01），均與血清MDA水平呈負相關（r=-0.334、-0.448，P＜0.05）。③ 加重期半胱氨酸轉化率（3.97 ± 2.41）低于緩解期（5.92 ± 2.18）與對照組（6.14 ± 3.15）差異有統計學意義（P＜0.05）；而胱硫醚轉化率則相反。④ 葉酸與維生素B12水平各組間均無差異。 結論 提高AECOPD患者維生素B6及H2S濃度可能能促使AECOPD患者向穩定狀態轉歸，減輕氧化應激損傷。維生素B6與H2S可能成為AECOPD患者的一個新的治療點。Objective To study the roles of homocysteine (Hcy) transsulfuration pathway, Vitamin B6 and endogenous hydrogen sulfide in treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixteen AECOPD patients and 13 healthy controls (Control group) from February to April 2010 were recruited in this study. Lung function, serum hydrogen sulfide (H2S), malondialdehyde (MDA), folate, vitamin B12, C-reactive protein (CRP), interleukin-6 (IL-6), Hcy, cystathionine, cystein (Cys) and vitamin B6 were all measured for all the patients in the acute exacerbation period and alleviation period and healthy controls. The conversion rate of Cys (expressed as Cys/cystathionine) and the conversion rate of cystathionine (expressed as cystathionine/Hcy) were calculated for analysis. Results Serum MDA level for patients in the acute exacerbation period (AE period) [(7.3 ± 5.1) nmol/L] was significantly higher than that in the alleviation period [(3.0 ± 1.4) nmol/L] and in the healthy controls [(3.0 ± 2.2) nmol/L] (P ＜ 0.01). Serum MDA level was negatively correlated with percentage of FEV1 in predicted FEV1 (FEV1% pred) and FEV1/FVC. Serum H2S level and plasma vitamin B6 level for patients in the AE period were significantly lower than those in the alleviation period and in the healthy controls (P ＜ 0.01), and serum H2S level was significantly higher in the alleviation period [(47.2 ± 5.1) μmol/L] than in the controls [(38.8 ± 2.1) μmol/L] (P ＜ 0.01). Both serum H2S and plasma vitamin B6 levels were correlated positively with FEV1% pred for patients in the AE period and healthy controls (r=0.651, 0.680; P ＜ 0.01), but negatively correlated with serum MDA level (r=-0.334, -0.448; P ＜ 0.05). The conversion rate of Cys for patients in the AE period (3.97 ± 2.41) was significantly lower than that in the alleviation period (5.92 ± 2.18) and the control group (6.14 ± 3.15) (P ＜ 0.05), but the conversion rate of cystathionine was just the opposite (P ＜ 0.05). There were no significant differences in the levels of serum folate and vitamin B12 among the three groups. Conclusion Raising the Vitamin B6 and H2S level may facilitate stabilizing of conditions in patients with AECOPD and reduce oxidative stress. Therefore, it may become a new treatment method for AECOPD.
摘要:目的: 探討動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)患者同型半胱氨酸(Hcy)變化。 方法 :通過循環酶法對34例非動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)患者(對照組),30例動脈硬化閉塞癥(ASO)患者和26例靜脈血栓形成(VT)患者血液中Hcy進行測定。 結果 :循環酶法測定HCY的批內平均變異系數為2．23％,批間平均變異系數為1．59％。34例對照組,〖WTBX〗t =1135,〖WTBX〗P =0266gt;005;動脈硬化閉塞癥(ASO)組Hcy含量明顯高于對照組(〖WTBX〗P lt;O．05),靜脈血栓形成(VT)組Hcy含量高于對照組(〖WTBX〗P lt;0．O5)。 結論 :高同型半胱氨酸血癥可能是動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)及復發的致病因素。可將同型半胱氨酸作為動脈硬化閉塞癥(ASO)和靜脈血栓形成(VT)及復發的重要指標。Abstract: Objective: TO syudy the changes of the Homocysteine about Atherosclerosis obliterans and Venous thrombosis patients. Methods : To measure the Hcy in the blood of 34 healthy cases both non ASO and non VT(the comparison group),30 cases of ASO patients and 26 cases of VT patients respectively by enzymatic cycling assay。〖WTHZ〗Results :The average variation coefficient of Hcy within the groups was 223% and among the groups was 159% measured by enzymatic cycling assay.In the 34 cases of comparison group,t=1135,P=0266gt;005,The content of Hcy in the blood of ASO patients group were significantly higher than the comparision group (Plt;005),and the content of Hcy in the blood of VT patients group were also higher than the comparison group (Plt;005). Conclusion : Hyper Hcy may be the pathogenic diathesis to form or to recrudesce ASO and VT.So we can treat Hcy as the significant index to form or to recrudesce ASO and VT.
Objective To explore the correlation between homocysteine （Hcy） level and the risk of breast cancer，and try to find a new method to reduce the risk factors and benefit for treatment of breast cancer. Methods From January2010 to December 2012， 245 cases of breast cancer （breast cancer group）， 109 cases of benign breast tumor （benign breast tumor group）， and 78 cases of healthy women （healthy control group） in the Sichuan Provincial People’s Hospital， who were in accordance with the inclusion criteria， were analyzed retrospectively. The difference of Hcy level was compared among three groups. Meanwhile the relation between Hcy level and patients’s age， blood glucose， serum creatinine， estrogen receptor （ER）， progesterone receptor （PR）， Ki-67 （%）， tumor diameter， or axillary lymph node status was analyzed.Results ① The Hcy level was significantly different among the breast cancer group， benign breast tumor group， and healthy control group （P＜0.001）. The Hcy level of the breast cancer group was significantly higher than those of the benignbreast tumor group （P＜0.001） or healthy control group （P＜0.001）， but the Hcy level was not significantly different bet-ween the benign breast tumor group and healthy control group （P=0.082） . ② The Hcy levels of different types of the breastcancer （type of Luminal A， Luminal B， Her-2， and triple negative） were significantly higher than those of the benign breast tumor group （except for Her-2 type， P＜0.05） or healthy control group （P＜0.05）. ③Plasma Hcy level of the patients with benign and malignant breast tumor was positively correlated with age （r=0.197， P=0.004） or serum creatinine level （r=0.381， P＜0.001）， but not correlated with blood glucose （r=0.023， P=0.668）. ④Plasma Hcy level of the patients with malignant breast tumor was positively correlated with age （r=0.267， P=0.007） or serum creatinine level （r=0.341， P＜0.001）， but not correlated with blood glucose （r=-0.005， P=0.935）， tumor diameter （r=-0.049， P=0.443）， axillary lymph node status （r=-0.006， P=0.921）， or Ki-67 （%） （rs=-0.029， P=0.650）. Conclusions Plasma Hcy level of breast cancer patient is abnormally elevated， and it may have some relation with the occurrence of breast cancer.
ObjectiveTo study the correlation between neck artery vascular sclerosis and homocysteine levels in hypertensive patients. MethodsA total of 2 132 patients with hypertension participated in the program of "Stroke screening and prevention in Dongying city" were included from Sep. 2012 to Jan. 2013. Questionnaire, physical examination, biochemical blood tests and carotid artery ultrasound were conducted in all included patients. According to the level of homocysteine (Hcy), patients were divided into three groups:716 patients with Hcy level less than 12.3 mm/L were in Group 1, 703 patients with Hcy level 12.3 to 16.5 mm/L were in Group 2, and 713 patients with Hcy level more than 16.5 mm/L were in Group 3. The influence of Hcy levels on carotid atherosclerosis was analyzed. Results① The prevalence rate for carotid plaques in Groups 1, 2, and 3 were 50.28%, 60.03% and 65.36%, respectively. The prevalence rate for carotid plaques in Group 2 was higher than that in Group 1 with a statistical difference (OR=1.485, 95% CI 1.203 to 1.833, P=0.000). The prevalence rate in Group 3 was also higher than that in Group 1 with a statistical difference (OR=1.866, 95% CI 1.508 to 2.308, P=0.000). ② The prevalence rate for carotid plaques was 62.24% in the rural population, and 52.39% in the urban population. The difference between urban and rural populations was statistically significant (OR=1.500, 95% CI 1.259 to 1.788, P=0.000). ③ Using the presence of carotid plaques as a dependent variable and Hcy level as a covariant, logistic regression analysis found that the plaque formation in Group 2 was 1.491 times than in Group 1 and the plaque formation in Group 3 was 1.752 times than in Group 1. After adjusting the risk factors (gender, age, BMI, TG, TC, LDL-C, HDL-C and blood sugar level), the results showed that the plaque formation in Group 2 was 1.388 times than in Group 1, and the plaque formation in Group 3 was 1.452 times than in Group 1. ConclusionThere is a correlation between the increased incidence of carotid plaque and homocysteine levels in patients with hypertension. The incidence of carotid plaque in the rural population with hypertension is higher than that in the urban population. In the population with hypertension, high homocysteine level is an independent risk factor for the formation of carotid plaques.
Objective To explore the relevance of serum homocysteine (Hcy) level to erythrocyte and platelet parameters in patients with unstable angina pectoris (UAP). Methods Sixty patients with UAP were collected in Tongling Municipal Hospital from August 1st, 2012 to December 31st, 2015. Serum Hcy was measured by enzymatic cycling method. Erythrocyte parameters, such as red blood cell count (RBC), hemoglobin, mean corpuscular volume (MCV), coefficient of variation of red blood cell volume distribution width (RDW-CV), and platelet parameters, such as platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (P-LCR), were measured with blood cell counter. All patients were classified into UAP with hyperhomocystinemia (HHcy) group and UAP with normal Hcy group according to the level of Hcy. The data in two groups were analyzed and the relevance of serum Hcy level to erythrocyte and platelet parameters was evaluated. Results The differences in the levels of RBC, hemoglobin, MCV, PLT, PDW, MPV, P-LCR between the two groups were not statistically significant (P>0.05); while the levels of RDW-CV and the proportion of RDW-CV above the upper reference limit of patients in the UAP with HHcy group (13.81%±1.13%, 39.4%) were higher than those in the UAP with normal Hcy group (13.06%±0.97%, 4.8%), and the differences between the two groups were statistically significant (P<0.05). Correlation analysis showed that serum Hcy level of patients with UAP was significantly correlated with RDW-CV (r=0.380, P<0.01) and was not significantly correlated with other erythrocyte and platelet parameters (P>0.05). Conclusion The high level of Hcy affects red blood cell volume heterogeneity in patients with UAP, which may be one of the mechanisms of HHcy participating in the occurrence and development of UAP.
ObjectiveTo investigate the relationship between the level of homocysteine (HCY) and the overall burden of cerebral small vessel disease (CSVD) in patients with ischemic stroke.MethodsA total of 322 patients with first-ever ischemic stroke admitted to the People’s Hospital of Deyang City between January 2016 and December 2017 were enrolled. The patients’ demographic information, clinical information, and serum HCY concentration were collected after admission. The presence or absence of a CSVD was assessed by MRI and the overall burden score for the CSVD was determined. Multivariate logistic regression analysis was used to assess whether serum HCY level was associated with the overall burden of CSVD.ResultsThe median level of HCY was 13.2 μmol/L (inter-quartile range: 4.3 to 22.6 μmol/L). Univariate analysis showed that the difference of HCY levels among patients with different total CSVD scores was statistically significant (F=6.874, P=0.001); Spearman correlation analyses showed that the HCY level grouped by quartiles was correlated to the number of lacunar infarctions (rs=0.267, P=0.001), Fazekas score of white matter lesions (rs=0.122, P=0.042), and enlarged perivascular space (EPV) score (rs=0.319, P=0.001), but was not correlated to cerebral microhemorrhage (rs=?0.010, P=0.869). After multivariate regression analysis to adjust the effects of other factors, compared with the patients with HCY levels in the lowest quartile group, the patients with HCY levels in the highest quartile group were more likely to develop lacunar infarction [odds ratio (OR)=1.892, 95% confidence interval (CI) (1.012, 2.987)], white matter lesions [OR=1.548, 95%CI (1.018, 1.654)], severe EPV [OR=6.347, 95%CI (3.592, 13.978)], and the increase in the CSVD score [OR=2.981, 95%CI (1.974, 5.398)].ConclusionIn patients with ischemic stroke, elevated HCY levels may be associated with the overall burden of the CSVD.
ObjectiveTo explore the concentration of the plasma homocysteine (Hcy) and the relationship with TOAST subtypes in patients with acute cerebral infarction. MethodsA total of 120 patients with acute cerebral infarction (ACI) treated from April 2012 to April 2013 were enrolled into the ACI group.They were classified with Korean TOAST classification as five subtypes:atherothrombosis (AT) type,small artery disease (SAD) type,cardioembolism (CE) type,stroke of other disease (SOD) type,and stroke of undetermined etiology (SUE) type.The plasma Hcy concentrations in each group and in 60 heathy people who were selected into the control group were measured.Furthermore,the relationship between plasma Hcy concentration and their subtypes were analyzed. ResultsThe plasma Hcy level in ACI group was significant higher than that in the control group (P<0.01).The levels of plasma Hcy were much higher in patients with AT,SAD,SOD,and CE than those in the control groups (P<0.01).In different subtypes,AT and SAD subtypes had higher homocysteine concentration than SUD and CE subtypes did.The concentration of Hcy in AT and SAD group had no significant difference. ConclusionACI is related to hyperhomocysteinemia.The plasma Hcy level varies with different TOAST subtypes of ACI,specially elevating in the subtypes of AT and SAD,which may indicate that hyperhomocysteinemia may increase stroke risk through proatherogenic effect and endothelial dysfunction.
ObjectivesTo evaluate the association between high homocysteine (Hcy) levels and risk of contrast-induced nephropathy (CIN).MethodsCNKI, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect the case-control studies on the association between Hcy and risk of CIN from inception to November 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software.ResultsTen case-control studies involving 6 124 subjects were included. Meta-analysis showed that the high Hcy level was associated with an increased risk of CIN (OR=1.59, 95%CI 1.33 to 1.89, P<0.001), and the homocysteine level in CIN group was higher than that in non-CIN group (WMD=8.74, 95%CI 6.18 to 11.31,P<0.001).ConclusionsAccording to the current evidence, the high Hcy level is a risk factor for CIN. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.