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Title:: Homocysteine levels and effects of B vitamins in patients with hyperhomocysteinemia and CHD

Author(s):: XU Hai-yan; CHEN Zai-jia; LIU Hai-bo; ZHANG Chun-ling; GU Qing; GUO Xiu-qin; Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, China

摘要:: 目的观察冠心病患者同型半胱氨酸（Hcy）水平与血浆叶酸、维生素B12浓度之间的关系，以及高同型半胱氨酸血症联合补充叶酸、维生素B6和维生素B12对Hcy水平的影响。方法冠心病患者332例，正常对照组194例。采用高压液相色谱法测定空腹血浆Hcy水平，应用放免分析法测定基础血浆叶酸及维生素B12浓度。Hcy水平高于15 μmol/L者为高同型半胱氨酸血症，随机分为治疗组（55例）和对照组（43例）,均为冠心病患者，治疗组予以每日补充叶酸5 mg, 维生素B6 20 mg,每日3次,维生素B12 0.5 mg,每日1次,4周后复查血浆Hcy水平。结果冠心病患者血浆Hcy水平高于正常组，基础叶酸浓度明显低于正常组，直线相关分析结果显示冠心病组血浆Hcy水平与基础叶酸浓度呈明显负相关(r=-0.149, P<0.05)，治疗组4周后Hcy水平平均降低了37.7%,治疗前后Hcy水平有显著差异(P<0.01)。结论冠心病患者Hcy水平较正常对照组显著升高，联合补充叶酸、维生素B6和维生素B12可明显降低冠心病患者高同型半胱氨酸血症者的血浆Hcy水平。

Abstract:: AIM To study the effects of nutritional factors (plasma folic acid and vitamin B12 concentrations) on plasma homocysteine (Hcy) levels in CHD patients with hyperhomocysteinemia. METHODS Plasma Hcy levels were determined by HPLC in patients with CHD and controls and the basic plasma folic acid and vitamin B12 concentrations were examined. The patients whose plasma Hcy levels were higher than 15 μmol/L were divided into therapy group and control group. Only the patients in therapy group were given folic acid 5 mg, vitamin B6 20 mg tid and B12 0.5 mg per day. Hcy levels in both groups were examined again four weeks later. RESULTS The plasma Hcy levels were higher and folic acid concentrations were lower in patients with CHD compared with those in control. The Hcy levels of the patients in therapy group decreased by 37.7% four weeks later. There was significant difference between the levels before and after therapy (P<0.01). CONCLUSION The Hcy levels in patients with CHD are markedly higher than those in control group. Supplement of folic acid, vitamin B6 and B12 decreases the plasma Hcy levels in the patients with hyperhomocysteinemia.