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目的 观察系统性红斑狼疮 (SLE)患者血浆中同型半胱氨酸 (Hcy)水平 ,分析影响Hcy的因素和某些心血管因素的变化。 方法 测定 2 7例SLE和 31名正常对照的Hcy、维生素B12 、叶酸、C反应蛋白 (CRP)、氧化低密度脂蛋白 (oxLDL)、一氧化氮 (NO)、丙二醛 (MDA)的水平和亚甲基四氢叶酸还原酶 (MTHFR)基因 6 77位的多态性。结果 ①SLE组Hcy水平明显较对照组高 ,其差异有显著性 [SLE组 (19± 7) μmol/L ,对照组 (12± 4 ) μmol/L ,P <0 0 0 1];②Hcy与维生素B12 、叶酸呈负相关 ,相关系数分别为 - 0 76 7和 - 0 6 7,P <0 0 0 0 1;③MTHFR基因 6 77位CT的突变使Hcy水平升高 [CC型 (12 8± 6 2 ) μmol/L ,CT型 (16 0± 2 1) μmol/L ,TT型 (18 9± 5 7) μmol/L ,P<0 0 0 1];TT基因型是高Hcy血症的易感基因 ,相对危险度 (RR) =31 4 9,P <0 0 5 ;TT基因型是SLE的易感基因 ,RR =6 913,P <0 0 5 ;④Hcy水平与NO、MDA、oxLDL呈正相关 ,并与CRP呈正相关。结论 ①SLE患者普遍有高Hcy血症。②导致高Hcy血症的原因包括叶酸、维生素B12 的水平降低和MTHFR基因的突变 ,TT型基因是Hcy异常升高的易感基因。③TT型基因也是SLE的易感基因。④高Hcy血症可能通过损伤血管内皮 ,大量产生氧自由基 ,加速低密度?
Objective To observe the level of plasma homocysteine (Hcy) in patients with systemic lupus erythematosus (SLE) and analyze the changes of Hcy and some cardiovascular factors. Methods The levels of Hcy, vitamin B12, folic acid, C-reactive protein (CRP), oxLDL, NO and MDA in 27 SLE patients and 31 normal controls were measured. And methylenetetrahydrofolate reductase (MTHFR) gene 677 polymorphism. Results ① The level of Hcy in SLE group was significantly higher than that in control group [(19 ± 7) μmol / L in SLE group and (12 ± 4) μmol / L in control group, P <0.01] B12 and folic acid were negatively correlated with correlation coefficients of -0.767 and -0.67 respectively (P <0.01). ③The mutation of 6th CTH in MTHFR gene increased the level of Hcy [CC (12 8 ± 6 2 μmol / L, CT 16 0 ± 2 1 μmol / L and TT 18 9 ± 5 7 μmol / L, P 0 01 0 respectively. The TT genotype was hyperhomocysteinemia The relative risk (RR) was 31 4 9, P 0 05. The TT genotype was a susceptible gene of SLE, RR = 6 913, P 0 05. The level of Hcy was positively correlated with NO, MDA, oxLDL was positively correlated with CRP was positively correlated. Conclusion ① SLE patients generally have high Hcy hyperlipidemia. Causes of hyperhomocysteinemia include folic acid, reduced vitamin B12 levels and mutations in the MTHFR gene, which are susceptible genes with an abnormally elevated level of Hcy. ③TT gene is also a susceptible gene of SLE. ④ hyperhomocysteinemia may damage the vascular endothelium, a large number of oxygen free radicals, accelerate the low density?