血清同型半胱氨酸、叶酸和维生素B_(12)在慢性肾脏病各期中的水平分析和临床意义

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目的分析血清同型半胱氨酸(homocysteine,Hcy)、叶酸(folate acid,FA)和维生素B_(12)(vitamin B_(12),Vit B_(12))在慢性肾脏病(chronic kidney disease,CKD)各期中的水平和临床意义。方法选取本院收治的CKD患者240例作为研究对象,根据CKD分期标准分为1期组31例、2期组39例、3期组58例、4期组40例、5期组72例,另选取50例健康体检者为对照组,检测5组患者和对照组血清Hcy、FA、Vit B_(12)水平和肾功能指标:血清尿酸(uric acid,UA)、肌酐(serum creatinine,Scr)以及血尿氮素(blood urea nitrogen,BUN)水平,并分析Hcy、FA、Vit B_(12)与肾功能指标的关系。结果与对照组比较,5组Hcy水平显著升高(P<0.05),5组FA、Vit B_(12)水平显著降低(P<0.05),5组UA、Scr、BUN水平均显著升高(P<0.05);Hcy与UA、Scr、BUN呈显著正相关(P<0.05),FA、Vit B_(12)与UA、Scr、BUN呈显著负相关(P<0.05)。结论 Hcy、FA、Vit B_(12)水平与慢性肾脏病分期以及肾功能存在密切联系,三者水平可有效反映CKD患者病情的发展与预后,在CKD临床诊疗中具有一定的参考价值。 Objective To investigate the correlation between serum homocysteine ​​(Hcy), folate acid (FA) and vitamin B 12 (vitamin B 12, Vit B 12) in patients with chronic kidney disease (CKD ) The level of the period and clinical significance. Methods A total of 240 patients with CKD admitted to our hospital were enrolled in this study. According to the criteria of CKD, there were 31 patients in stage 1, 39 in stage 2, 58 in stage 3, 40 in stage 4, 72 in stage 5, Another 50 healthy subjects were selected as the control group. Serum levels of Hcy, FA, Vit B 12 and renal function were measured in 5 groups of patients and controls: serum uric acid (UA), serum creatinine (Scr) And blood urea nitrogen (BUN) levels were analyzed. The relationship between Hcy, FA, Vit B 12 and renal function was analyzed. Results Compared with the control group, the levels of Hcy in 5 groups were significantly increased (P <0.05), the levels of FA and Vit B 12 in 5 groups were significantly decreased (P <0.05), the levels of UA, Scr and BUN in 5 groups were significantly increased P <0.05). There was a significant positive correlation between Hcy and UA, Scr and BUN (P <0.05). There was a significant negative correlation between FA, Vit B 12 and UA, Scr and BUN (P <0.05). Conclusions The levels of Hcy, FA and Vit B 12 are closely related to the stage of chronic kidney disease and renal function. The levels of Hcy, FA and Vit B 12 can effectively reflect the development and prognosis of patients with CKD and may be of reference value in the clinical diagnosis and treatment of CKD.
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