叶酸对Budd-Chiari综合征患者支架术后血浆同型半胱氨酸浓度及再狭窄的影响  

Folate on plasma hypercoagulable in BCS patients after stent Implantation and on the inflenction of in-stent restenosis

作　　者：黄琰[1] 李敬东[1] 吴隼[1] 闫轶鹏[1] 杨瑞民[1] 郑庆芬[1] 王黎伟[1] 贺立山[1] 

机构地区：[1]新乡医学院第一附属医院血液科

出　　处：《临床内科杂志》2010年第10期688-690,共3页Journal of Clinical Internal Medicine

摘　　要：目的 探讨叶酸对Budd-Chiari综合征（BCS）患者支架术后血浆同型半胱氨酸（Hcy）浓度的干预效果及其对下腔静脉或肝静脉再狭窄的影响.方法 选择接受过腔内支架置入术随访复查的56例Budd-Chiari综合征患者为研究对象,将56例患者分为叶酸组（30例）和对照组（26例）2组.高效液相色谱法分析术后1周、3个月、半年血浆Hcy水平,在相同的时间段复查彩色多普勒评估血管再狭窄情况,化学发光法测量治疗前后血浆叶酸的浓度.结果 对Budd-Chiari综合征患者应用叶酸治疗后血浆Hcy浓度明显低于治疗前,差异有显著性（P＜0.01）,术后半年30例叶酸组患者中有3例发生再狭窄,再狭窄率为10.0%;对照组常规治疗后血浆Hcy浓度较治疗前无明显变化（P＞0.05）,有10例发生了再狭窄,再狭窄率为38.5%,与叶酸组比较差异有显著性（P＜0.05）.结论 叶酸可降低Bucld-Chiari综合征患者血浆Hey浓度,血浆Hcy水平与血清叶酸水平呈负相关（r=-0.833）;叶酸有降低Budd-Chiari综合征患者支架术后下腔静脉或肝静脉早期（术后半年）再狭窄率的作用.Objective To explore the effect of folate to plasma hypercoagu in BCS patients after stent implantation and on the inflenction of in-stent restenosis. Method 56 patients with BCS who were treated with stent implantation were randomly divided into 2 groups ： folate group （ n=30） and control group （ n = 26）. By means of colored Doppler ultrasound, whether the bracket was fluent or not and the degree of restenosis were evaluated. The Hcy level in the hepatic venous blood was determined with HPLC and plasma levels of folacin were measured with chemiluminescent method. The correlative data were analyzed by SPSS 13.0 statistical software. Results The plasma Hcy levels from BCS six months after operation were significantly lower than those before treatmeat, there was a significant difference （P 〈 0.01 ）. 30 patients with BCS in folate group and two cases have restenosis by the time of six months. The rate of restenosis was 10.0%. 26 patients with BCS in control group and seven cases had restenosis. The rate of restenosis was 38.5 %. There were more cases than the folate group （χ2 = 4. 834 ;P 〈 0.05 ） by comparing the two groups. Conclusions The results suggested that folate could reduce the level of the Hcy while the Hcy level was negatively correlated to the level of folate in the patients with BCS（ r = -0. 833, P 〈 0.01 ）. Folate could reduce inferior vena cava or hepatic vein early restenosis rate after six months in BCS patients with in-sent.

关 键 词：同型半胱氨酸 Budd—Chiari综合征 叶酸 再狭窄 

分 类 号：R543[医药卫生—心血管疾病]