肝衰竭患者血浆总同型半胱氨酸水平的检测  

Measurement of plasma total homocysteine levels in liver failure patients

作　　者：刘欢[1] 韩涛[1] 于美丽[1] 

机构地区：[1]天津医科大学研究生院天津市第三中心医院肝内科天津市肝胆疾病研究所,天津市300070

出　　处：《世界华人消化杂志》2008年第24期2775-2779,共5页World Chinese Journal of Digestology

基　　金：国家重点基础研究发展规划(973计划)资助项目;No.2007CB512800;天津市卫生局重点攻关资助项目;No.07KG9~~

摘　　要：目的:探讨肝衰竭患者血浆总同型半胱氨酸(tHcy)水平与肝衰竭的关系.方法:采用高效液相色谱法测定96例肝衰竭、37例慢性肝病非肝衰竭患者及55例健康者血浆tHcy含量,同时检测肝衰竭患者血清丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBIL)、胆碱酯酶(CHE)、白蛋白(ALB)、前白蛋白(PALB)、葡萄糖(GLU)、肌酐(Cr)含量,以及患者血浆中20种氨基酸的水平,并观察血浆tHcy与各生化指标的相关性.结果:肝衰竭、非肝衰竭患者血浆tHcy水平与正常对照相比明显升高,差异有统计学意义(14.38±5.85,12.44±5.39μmol/Lvs10.29±1.96μmol/L;P=0.000,0.042),异常检出率分别为60.24%、40.54%;慢加急慢性肝衰患者较慢性肝衰竭患者血浆tHcy水平稍高,差别无统计学意义;tHcy变化与ALT、AST、ALB、TBIL、PALB、Cr、BCAA/AAA各临床指标无明显相关性,只有与蛋氨酸(MET)成正相关(r=0.297,P<0.05);患者死亡与生存组血浆tHcy水平无明显差别.结论:肝衰竭患者血浆tHcy水平显著升高,但其尚不能作为评价肝衰竭患者预后的指标.AIM： To investigate the relationship between plasma total homocysteine （tHcy） levels and liver failure. METHODS： Plasma tHcy in 96 liver failure patients, 37 non-failure patients and 55 healthy controls were measured by high performance liquid chromatography （HPLC）. Serum ALT, AST, TBIL, CHE, ALB, PALB, GLU, Cr and amino acid levels in liver failure patients were also detected, and meanwhile, their relationship with plasma tHcy was analyzed. RESULTS： The levels of plasma tHcy in liver failure and non-failure patients were significantly higher than those in the healthy controls （14.38 ± 5.85, 12.44 ± 5.39 μmol/L vs 10.29 ± 1.96 μmol/L; P = 0.000, 0.042）, and 60.24%, 40.54% of the patients showed significantly higher tHcy levels. Plasma tHcy levels in the acute-onchronic liver failure patients were a little higher than those in the chronic liver failure patients. There were weak correlations between plasma tHcy levels and ALT, AST, ALB, TBIL, PALB, Cr, and BCAA/AAA, but there was significantly positive correlation between tHcy and methionine （r = 0.297, P 〈 0.05）. The level of tHcy had no marked relation between survivors and the dead. CONCLUSION： The level of plasma tHcy is obviously elevated in liver failure patients, but it can not be used to evaluate the prognosis of liver failure.

关 键 词：肝衰竭 同型半胱氨酸 生物化学 高效液相色谱 

分 类 号：R575.3[医药卫生—消化系统]