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目的 探讨妊娠高血压综合征(妊高征)患者血浆总同型半胱氨酸(tHcy)水平检测的临床意义。方法 采用美国雅培公司生产的IMX全自动快速免疫分析仪中的荧光偏振免疫分析法检测血浆tHcy水平。同步取静脉血检测血清叶酸、维生素B12的浓度。病例选自产科收治的妊高征患者162例,对照组为150例年龄匹配的正常晚期妊娠妇女。结果 (1)妊高征组与对照组比较,血浆tHcy水平差异有非常显著意义;血清叶酸浓度差异无显著意义;血清维生素B12的浓度差异无显著意义。(2)妊高征组中,轻度、中度、重度患者tHcy水平,重度患者明显高于中度患者,中度患者明显高于轻度患者。(3)34 例重度患者,随机分为三组,给予口服叶酸:第1组(10例)5 mg,qd;第2组(12例)5 mg,tid;第3组(12例)10 mg,tid,疗程均为10 d,治疗前后血浆tHcy水平比较,第1组差异无显著意义;第2 组差异有非常显著意义;第3 组差异有非常显著意义。治疗后第2、3组血浆tHcy水平比较差异无显著意义。结论 妊高征患者血浆tHcy水平明显升高,且随着病情的加重,血浆tHcy水平呈逐渐上升趋势,监测血浆tHcy水平对了解妊高征病情具有重要意义;一定剂量的叶酸可显著降低重度妊高征患者的血浆tHcy水平,减少高Hcy对血管的毒性作用,有助于改善妊高征患者的疾病转归。
Objective To investigate the clinical significance of plasma total homocysteine (tHcy) level in patients with pregnancy induced hypertension (PIH). Methods Plasma tHcy levels were measured by fluorescence polarization immunoassay in the IMX automated rapid immunoassay analyzer manufactured by Abbott Laboratories. Synchronous venous blood was taken to measure the concentration of serum folate and vitamin B12. Cases were selected from obstetrics admitted to PIH patients in 162 cases, the control group of 150 age-matched normal late pregnancy women. Results (1) Compared with control group, the difference of plasma tHcy level in PIH group was significant. There was no significant difference in serum folate concentration between the PIH group and control group. There was no significant difference in serum vitamin B12 concentration between the two groups. (2) In the PIH group, the levels of tHcy in mild, moderate and severe patients were significantly higher than those in moderate and severe cases, and those in moderate PIH were significantly higher than those in mild PIH. (3) 34 severe patients were randomly divided into three groups and given oral folic acid: group 1 (10 cases) 5 mg, qd; group 2 (12 cases) 5 mg, tid; group 3 mg, tid, the course of treatment was 10 d, plasma tHcy levels before and after treatment, no significant difference between the first group; the second group of differences have a very significant significance; the third group differences have very significant significance. There was no significant difference in the levels of plasma tHcy in the second and third groups after treatment. Conclusions Plasma tHcy levels in patients with PIH were significantly increased, and as the disease progressed, the level of tHcy in plasma showed a gradual upward trend. Monitoring plasma tHcy level is of great significance for understanding the status of PIH. A certain dose of folic acid can significantly reduce severe pregnancy Hypertension in patients with plasma tHcy levels, reduce high Hcy toxic effects on blood vessels, help to improve the disease outcome of patients with pregnancy induced hypertension.