血清同型半胱氨酸、叶酸和维生素B_(12)浓度检测在非酒精性脂肪性肝病患者中的临床应用  

Determination of serum homocysteine,folate and vitamin B_(12) in patients with nonalcoholic fatty liver disease

作　　者：周颖[1] 俞萍[1] 金惠[1] 

机构地区：[1]上海市徐汇区中心医院消化内科,上海200031

出　　处：《内科理论与实践》2011年第6期431-434,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:探讨血清同型半胱氨酸(Hcy)、叶酸和维生素B12浓度检测在非酒精脂肪性肝病(NAFLD)患者诊断中的临床意义。方法:根据CT检查结果将符合临床诊断标准的123例NAFLD患者分为轻度、中-重度脂肪肝组,以同期体检健康者139名作为对照组,测定血清Hcy、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、叶酸和维生素B12浓度,并进行Hcy与叶酸、维生素B12浓度的相关性分析。结果:中-重度NAFLD患者的Hcy、ALT、AST、TC、TG均明显高于轻度NAFLD组和健康对照组,HDL、维生素B12水平明显低于轻度NAFLD组和健康对照组(P<0.05)。轻度NAFLD组ALT、Hcy明显高于健康对照组,HDL明显低于健康对照组(P<0.05),并且血清Hcy与叶酸、维生素B12呈直线负相关。结论:NAFLD患者Hcy水平随着肝脏脂肪变性的加重而升高,高Hcy血症可能是NAFLD一个新的危险因素,提示Hcy在NAFLD发病中起一定作用。并且叶酸、维生素B12水平与Hcy水平具有相关性。Objective To investigate the clinical significance of serum homocystei＇ne （Hcy）,folate and vitamin B12 in nonalcoholic fatty liver disease （NAFLD）. Method One hundred and twenty-three patients with nonalcoholic fatty liver disease were divided into mild NAFLD and moderate/severe NAFLD according to CT results, and 139 healthy subjects served as controls. Serum levels of Hcy, alanine transaminase （ALT）, aspartate transaminase （AST）, total cholesterol （TC）, triglyeeride （TG）, high density lipoprotein（HDL）, low density lipoprotein（LDL）, folate and vitamin B12 were determined and their correlations were analyzed. Result Levels of Hey and ALT, AST,TG,TC in moderate / severe NAFLD group were higher than that in normal control group and mild NAFLD group,and levels of HDL and vitamin B12 were lower than that in normal control group and mild NAFLD group （P〈0.05）. Levels of Hey and ALT in mild NAFLD group were higher than that in normal control group, and level of HDL was lower than in that in normal control group （P〈0.05）. An inverse linear correlation existed between level of Hcy and levels of folate and vitamin B12. Conclusion Serum level of Hcy increases with the increase in fatty degeneration of liver, and hyperhomocysteinemia may be a novel risk factor of NAFLD. Levels of folate and vitamin B12 are correlated inversely with level of Hcy.

关 键 词：非酒精性脂肪肝 同型半胱氨酸 叶酸 维生素B12 危险因素 

分 类 号：R575.5[医药卫生—消化系统]