肝豆状核变性患者血浆同型半胱氨酸与脂蛋白(a)、叶酸等的相关性研究  

Correlation between plasma homocysteine and lipoprotein(a), folate etc. in patients with hepatolenticular degeneration

作　　者：王翼洁 胡文彬[2] 余小玲[1] 吴君霞[2] 韩咏竹[2] 胡纪源[2] 王训[2] 李凯[2] 王共强[2] 杨任民[2] 

机构地区：[1]安徽中医药大学,合肥230038 [2]安徽中医药大学神经病学研究所附属医院

出　　处：《中华临床医师杂志（电子版）》2014年第20期6-10,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81072738;81473535);安徽中医药大学临床科研基金(2014lckf02039;2014lckf02002;2014lckf02012;2014lckf02017;2014lckf02018;2014lckf02031)

摘　　要：目的探讨肝豆状核变性(HLD)患者同型半胱氨酸与血浆脂蛋白(a)、维生素B12、叶酸相关性及与驱铜治疗的关系。方法将63例HLD住院患者分为33例HLD规范治疗组(规范组)和30例HLD非规范治疗组(非规范组),测定二巯基丙磺酸钠(DMPS)驱铜疗程前血浆同型半胱氨酸(Hcy)、脂蛋白(a)、维生素B12及叶酸的水平,并留取患者疗前和第一个DMPS驱铜疗程中的24 h尿铜,以35例正常人为健康对照组。结果非规范组患者血浆Hcy异常率显著高于规范组及对照组(P<0.016 7),而规范组与对照组Hcy异常率无统计学差异(P>0.05)。三组患者脂蛋白(a)、叶酸均有统计学差异(P<0.05),而维生素B12水平无统计学差异(P>0.05)。非规范组疗前、第一疗程尿铜显著高于规范组(P<0.05),且非规范组患者血浆Hcy与第一疗程尿铜呈线性正相关。对照组血浆维生素B12、叶酸对Hcy具有显著负相关,而脂蛋白(a)对Hcy具有不显著正相关。结论未经规范化驱铜治疗的HLD患者更易合并高Hcy血症;HLD患者存在脂蛋白(a)的代谢异常及叶酸缺乏情况;正常人的血浆脂蛋白(a)、叶酸、维生素B12水平与血浆Hcy水平存在相关性,但有关HLD的相关性有待进一步研究。Objective To explore the correlation between plasma homocysteine and lipoprotein （a）, folate, Vitamin B12 in hepatolenticular degeneration（HLD） and the relationship with decoppering therapy. Methods 63 inpatients of HLD were divided into 33 cases of standardized treatment group（specification group） and 30 cases of non-standardized treatment group（non-specification group）. The serum concentration of homocysteine（Hcy）, lipoprotein （a）, folate and vitamin B12 were measured before decoppering therapy with sodium dimercaptosulphonate（DMPS）, 24-hour urine copper were remained before drug treatment and after first period treatment with DMPS. 35 cases of normal served as controls（control group）. Results The abnormal rate of serum Hcy in non-specification group was higher than that in specification group and control group（P〈0.05）, but there was no statistical significance between specification group and control group（P〉0.05）. The concentration of lipoprotein （a） and folate between three groups had statistical significance（P〈0.05）, but vitamin B12 among the three groups present no statistical significance（P〉0.05）. 24-hour urine before drug treatment and after first period treatment with DMPS in non-specification group were higher than that in specification group（P〈0.05）, and 24-hour urinenbsp;after first period treatment with DMPS had positively linearly related to serum Hcy in non-specification group. The serum concentration of vitamin B12 and folate had a significant negatively related to Hcy in control group, but lipoprotein（a） had no significant positively related to Hcy. Conclusions HLD patients without standardized decoppering therapy are more easily complicated with hyperhomocysteine. HLD patients have metabolic abnormalities of lipoprotein（a） and folate deficiency. The correlation between hyperhomocycteinemia and lipoprotein（a）, folate, vitamin B12 is existed in normal human, but this correlation in HLD patients remains to be further expl

关 键 词：肝豆状核变性 同型半胱氨酸 驱铜治疗 

分 类 号：R742.4[医药卫生—神经病学与精神病学]