论文部分内容阅读
目的 分析多种风湿性疾病患者血浆中同型半胱氨酸(Hcy)水平及其相关因素。方法脊柱关节病(uSpA)患者和 62例正常对照的Hcy、VitB12、叶酸的水平和亚甲基四氢叶酸还原酶(MTHFR)基因 677位的多态性。结果 (1)各疾病组Hcy水平分别为:SLE组 (19 04±6 86)μmol/L,RA组(19 07±7 43)μmol/L,AS组(16 47±6 50)μmol/L,uSpA组(16 59±6 72)μmol/L,对照组(12 24±3 58)μmol/L,各疾病组Hcy水平明显较对照组高,其差异有统计学意义 (P<0 01 ); ( 2 )Hcy与VitB12、叶酸呈负相关,相关系数分别为-0 701和-0 443,P<0 01; (3)MTHFR基因 677位C→T的突变使Hcy水平升高, CC型 ( 13 41±5 78 )μmol/L,CT型 ( 16 81±4 22 )μmol/L,TT型(20 88±6 60)μmol/L,P<0 01;TT基因型是高Hcy血症的易感基因 (OR=84 46,P<0 05);TT基因型还是SLE的易感基因(OR=7 56,P<0 05)。结论 (1)SLE、RA、AS、uSpA4种疾病患者普遍存在高Hcy血症。(2)导致高Hcy血症的原因可能有叶酸、VitB12的水平降低和MTHFR基因的突变。(3)TT型基因是Hcy异常升高的易感基因,也是SLE的易感基因。
Objective To analyze plasma homocysteine (Hcy) level and its related factors in patients with various rheumatic diseases. Methods The levels of Hcy, VitB12, folic acid and polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene 677 in patients with spondyloarthropathies (uSpA) and 62 normal controls were determined. Results (1) The levels of Hcy in each disease group were 19 04 ± 6 86 μmol / L in SLE group, 19 07 ± 7 43 μmol / L in RA group and 16 47 ± 6 50 μmol / L in AS group, respectively , uSpA group (16 59 ± 6 72) μmol / L, and control group (12 24 ± 358 μmol / L). The levels of Hcy in each disease group were significantly higher than those in control group (P <0.01) ; (2) There was a negative correlation between Hcy and VitB12 and folic acid, the correlation coefficients were -0 701 and -0 443, respectively (P <0.01); (3) The mutation of 6TH C → T of MTHFR gene increased the level of Hcy, (13 41 ± 5 78) μmol / L, CT 16 81 ± 4 22 μmol / L and TT 20 88 ± 6 60 μmol / L, respectively (OR = 8446, P <0.05). TT genotype was also a susceptible gene of SLE (OR = 7 56, P <0 05). Conclusions (1) Hyperhomocysteinemia is common in patients with SLE, RA, AS and uSpA4 diseases. (2) The cause of hyperhomocysteinemia may be folic acid, decreased levels of VitB12 and mutations in the MTHFR gene. (3) TT gene is a susceptible gene with abnormally increased Hcy and is also a susceptible gene of SLE.