| 72例克罗恩病患者中血清同型半胱氨酸、叶酸和维生素B12水平分析 |
| 投稿时间：2016-06-28 修订日期：2016-07-01 点此下载全文 |
| 引用本文：姜宏刚,林秀清,吴小丽,姜利佳,丁然,蒋益.72例克罗恩病患者中血清同型半胱氨酸、叶酸和维生素B12水平分析[J].医学研究杂志,2017,46(3):78-81,90 |
| DOI：
10.11969/j.issn.1673-548X.2017.03.020 |
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| 基金项目:浙江省自然科学基金资助项目（LY14H030012）；浙江省卫生厅基金资助项目（2012KYA132） |
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| 中文摘要:目的 探讨血清同型半胱氨酸（homocysteine，Hcy）、叶酸和维生素B12水平与克罗恩病（Crohn's disease，CD）的关系。方法 收集72例CD患者和128名性别、年龄相匹配的健康对照者，采用简化克罗恩病活动指数（CDAI）评估CD疾病活动度。采用循环酶法检测Hcy水平，化学发光免疫法检测叶酸和维生素B12水平。采用Pearson相关性分析和多元线性回归分析探讨CD组中Hcy水平与CDAI评分及叶酸、维生素B12、白蛋白等血清学指标的关系。最后采用Logistic回归分析评估CD的独立危险因素。结果 与对照组相比较，CD组中Hcy平均水平显著增高（P=0.002），而叶酸和维生素B12平均水平显著降低（P均=0.000）。CD组中高同型半胱氨酸血症（>15.0μmol/L）、叶酸缺乏（<4.0ng/ml）和维生素B12缺乏（<203.0pg/ml）比例均显著高于对照组（P均<0.01）。与缓解期患者（CDAI<5）比较，活动期CD患者（CDAI≥5）中Hcy平均水平显著增高（P=0.001），而叶酸和维生素B12平均水平显著降低（P均=0.000）。经性别、年龄因素校正后，多元线性回归分析显示CD组中Hcy水平与叶酸和维生素B12呈独立负相关（β=-0.262，P=0.037；β=-0.293，P=0.020）。Logistic回归分析结果提示叶酸缺乏和维生素B12缺乏为CD的独立危险因素（OR=4.421，P=0.006；OR=9.036，P=0.000）。结论 浙江籍汉族CD患者中可能普遍存在高同型半胱氨酸血症、叶酸缺乏和维生素B12缺乏，血清Hcy、叶酸和维生素B12水平与CD疾病活动度密切相关，叶酸缺乏和维生素B12缺乏是CD的独立危险因素。 |
| 中文关键词:克罗恩病 同型半胱氨酸 叶酸 维生素B12 |
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| An Analysis of Serum Homocysteine, Folate and Vitamin B12 Levels in Seventy Two Patients with Crohn's Disease from Southeast China |
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| Abstract:Objective To investigate the associations of Crohn's disease (CD) with serum homocysteine (Hcy), folate and vitamin B12 levels in Chinese patients. Methods A total of 72 patients with CD and 128 healthy controls were recruited. The simplified Crohn's disease activity index (CDAI) was used to assess the activity of disease in CD patients. Serum Hcy, folate and vitamin B12 levels were determined by enzymatic cycling assay and chemiluminescence immunoassay, respectively. Pearson correlation analysis and multiple linear regression analysis were applied to analyze the associations of Hcy level with CDAI and several laboratory parameters of CD patients, such as folate, vitamin B12 and albumin (Alb). In addition, Logistic regression analysis was employed to evaluate the independent risk factors for CD. Results As compared to controls, average Hcy level was significantly enhanced in CD patients (P=0.002), whereas average folate and vitamin B12 levels were significantly decreased in CD patients (both P=0.000). The ratios of hyperhomocysteinemia (>15.0μmol/L), folate deficiency (<4.0ng/ml) and vitamin B12 deficiency (<203.0pg/ml) were significantly higher in CD patients than in controls (all P<0.01). Compared to patients with remission stage, average Hcy level was markedly increased in patients with active stage (P=0.001), while average levels of folate and vitamin B12 were significantly decreased in patients with active stage (both P=0.000). After the adjustment of age and gender, multiple linear regression analysis showed that Hcy level was negatively correlated with folate and vitamin B12 levels in patients with CD (β=-0.262, P=0.037; β=-0.293, P=0.020, respectively). Furthermore, logistic regression analysis indicated that both folate deficiency and vitamin B12 deficiency were the independent risk factors for CD (OR=4.421, P=0.006; OR=9.036, P=0.000, respectively). Conclusion Hyperhomocysteinemia, folate deficiency and vitamin B12 deficiency might be common phenomena in CD patients from Zhejiang province, China. Moreover, serum levels of Hcy, folate and vitamin B12 were significantly correlated with the activity of CD in this cohort of Chinese patients. Both folate deficiency and vitamin B12 deficiency were the independent risk factors for CD. |
| keywords:Crohn's disease Homocysteine Folate Vitamin B12 |
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