血清同型半胱氨酸及叶酸水平与先天性心脏病的关系  

Relations between serum homocysteine and folic acid levels with congenital heart disease

作　　者：朱文丽[1] 刀京晶[1] 成君[1] 李书琴[2] 李勇[1] 

机构地区：[1]北京大学医学部营养与食品卫生学系,北京10008 [2]中国医科大学附属第二医院

出　　处：《卫生研究》2005年第6期740-743,共4页Journal of Hygiene Research

基　　金：达能营养中心"膳食营养研究与宣教基金"资助项目(No.DIC200208)

摘　　要：目的了解先天性心脏病(CHD)患者及其父母血清同型半胱氨酸(Hcy)及叶酸水平与CHD发生的关系。方法以核心家庭为基础的病例对照设计,在辽宁省选择CHD患者151人及其生物学父母作为病例组,另选取同地区无出生缺陷病史及家族史的98名正常人及其生物学父母作为相应对照。采用荧光免疫偏振法检测部分子代及其母亲的血清总Hcy(tHcy)水平,放射免疫法测定全部对象血清叶酸和维生素B12(VB12)水平。结果CHD患者及其母亲血清tHcy水平与对照组相比无明显差异;两组血清叶酸水平及叶酸缺乏率(<7nmolL)差异亦无显著性;与对照组相比,CHD患者血清VB12水平明显较高(315.36pmolL和185.34pmolL,P<0.05),VB12缺乏率(<150pmolL)明显较低,CHD组父亲血清VB12缺乏率也低于相应对照。分类型分析显示室间隔缺损患者血清tHcy水平明显低于对照组,而VB12水平明显高于对照;动脉导管未闭组父母血清叶酸水平均高于相应对照(P<0.05)。相关性分析表明亲代叶酸、VB12水平与子代呈明显正相关;病例组母亲tHcy水平与子代tHcy正相关,子代tHcy与叶酸水平负相关;对照组子代tHcy与VB12水平负相关(P<0.05)。结论叶酸及VB12是影响血清Hcy水平的重要因素,呈明显负相关;本研究尚不能得出叶酸及Hcy与CHD相关的结论,有待进一步研究。Objective To investigate the relations between serum homocysteine （Hcy） and folic acid with congenital heart disease （CHD） in CHD nuclear families. Methods In Liaoning Province 151 CHD patients and their biological parents were selected as the case group, with another 98 normal subjects and their parents as control. For some filial individuals and their mothers the serum total Hcy （tHcy） levels were detected by fluorescence polarization immunoassay. And for all members the serum levels of folic acid and vitamin B12 （VB12） were determined by radio-immunoassav. Results There were not significantly differences in the serum tHey and folic acid levels and theirs abnormality prevalence between CHD patients and the control, neither were their parents in the study. Compared with the control group the serum VB12 levels of CHD patients were apparently higher （315.36pmol/L and 185.34pmol/L, P 〈 0.05）, and the VB12 deficiency prevalence of patients and their fathers were lower. Analysis of different CHD types showed that in ventricular septal defect patients the serum tHey levels were lower than the control with VB12 levels higher, and in parents of patent ductus arteriosus patients the serum folic acid levels were increased （P 〈 0.05）. The study also indicated that the folic acid and VB12 of parents were significantly positively associated with that of filial generation. In the case group the tHey levels of mothers were positively correlated with filial generation, and in CHD patients the tHey was negatively associated with folic acid. In filial individuals of the control group the tHey was negatively related with VB12 （ P 〈 0.05 ）. Conclusion Folic acid and VB12 were important influencing factors of serum Hey and they were negatively correlated. In this study, the folic acid and Hey were not significantly related with CHD, and it needsfurther investigations to confirm it.

关 键 词：同型半胱氨酸 叶酸 先天性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病] Q563.8[医药卫生—内科学]