纳络酮对脑梗塞患者血清降钙素原及叶酸水平及临床疗效的影响

目的:探讨纳络酮对脑梗塞患者血清降钙素原、叶酸水平及临床疗效的影响。方法:收集我院收治的110例急性脑梗死患者,随机分为实验组和对照组,每组55例。两组患者入院后根据实际情况给予抗血小板聚集,保护脑细胞,调控血压,脱水降低颅内压降颅压等对症治疗。对照组患者给予疏血通注射液6 m L+0.9%氯化钠注射液250 m L静脉滴注,1次/d;实验组患者在对照组基础上给予盐酸纳洛酮注射液3.2 g/d,+0.9%氯化钠注射液250 m L静脉滴注,治疗疗程为14 d。观察并比较两组患者治疗前后血清降钙素原(PCT)、同型半胱氨酸(Hcy)、叶酸水平以及临床治疗有效率。结果:与治疗前相比,两组患者治疗后的血清PCT、Hcy水平均显著下降,叶酸水平均明显升高,差异均具有统计学意义(P0.05);与对照组相比,实验组患者的PCT、Hcy水平较低,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后的血清叶酸水平、临床治疗有效率均较高,差异具有统计学意义(P0.05)。结论:纳络酮能够显著提高脑梗塞患者的临床疗效,可能与其减轻炎症反应,降血清Hcy水平,升高血清叶酸水平有关。     

血清Hcy，叶酸和维生素B12在胃癌及其癌前疾病中的作用

目的:探讨血清同型半胱氨酸(Hcy)、叶酸以及维生素B12在胃癌及癌前疾病中的水平及临床意义。方法:收集2014年1月至2016年8月我院收治的100例胃癌患者(胃癌组),及100例胃良性病变患者包括41例胃炎、34例胃溃疡、25例胃息肉(癌前病变组),并于同期随机选择200例健康体检者为对照组,采用循环酶法测定三组的血清Hcy,电化学发光免疫分析法测定叶酸及维生素B12水平,并分析各指标与胃癌临床病理特征的关系。结果:胃癌组、癌前病变组血清Hcy水平均高于对照组,叶酸及维生素B12水平均低于对照组,并且胃癌组血清Hcy水平高于癌前病变组,叶酸及维生素B12水平低于癌前病变组,差异有统计学意义(P0.05)。Ⅲ+Ⅳ期胃癌患者Hcy水平高于Ⅰ+Ⅱ期,进展期患者Hcy水平高于早期,有淋巴结转移患者Hcy水平高于无转移者,差异有统计学意义(P0.05);Hcy表达与性别、年龄、病变位置以及分化程度无关,差异无统计学意义(P0.05)。叶酸、维生素B12的表达在胃癌患者中与各临床病理特征(性别、年龄、TNM分期、肿瘤浸润深度、病变位置、有无淋巴结转移、分化程度)无明显关系,差异无统计学意义(P0.05)。结论:血清Hcy在胃癌患者中呈高水平表达,而叶酸及维生素B12呈低水平表达,联合检测三种指标有助于早期区分胃癌及癌前病变,同时血清Hcy还可能参与了胃癌的发生发展过程。Hcy、叶酸及维生素B12可作为早期鉴别诊断胃癌及其癌前病变的重要指标。     

同型半胱氨酸与动脉粥样硬化

高同型半胱氨酸血症 (HH)是引起动脉粥样硬化的危险因素 ,可通过增加机体氧化应激因子的细胞毒性作用 ,损害内皮细胞而引起动脉粥样硬化。某些营养素可以防治HH引起的动脉样硬化症状。     

同型半胱氨酸、子宫动脉血流参数与反复妊娠丢失患者胰岛素抵抗和妊娠结局的关系

摘要 目的：探讨同型半胱氨酸（Hcy）、子宫动脉血流参数与反复妊娠丢失（RPL）患者胰岛素抵抗和妊娠结局的关系。方法：选择2020年6月至2022年10月昆明市妇幼保健院收治的162例RPL患者作为RPL组和同期82例规律产检的健康孕妇作为对照组。按照妊娠结局将RPL患者分为活产组（85例）和流产组（77例）。检测血清Hcy水平,胰岛素抵抗指数（HOMA-IR）,超声检查子宫动脉血流参数,包括子宫动脉收缩期峰值/舒张末期流速（S/D）、搏动指数（PI）、血流阻力指数（RI）。Pearson相关性分析Hcy、子宫动脉血流参数与HOMA-IR的相关性。采用多因素Logistic回归分析RPL 患者妊娠结局的影响因素。采用受试者工作特征（ROC）曲线分析Hcy、子宫动脉血流参数对RPL 患者妊娠结局的预测价值。结果：RPL组血清Hcy水平,S/D、PI、RI以及HOMA-IR均高于对照组（P＜0.05）。RPL组血清Hcy,S/D、PI、RI与HOMA-IR均呈正相关（P＜0.05）。流产组血清Hcy水平,S/D、PI、RI以及HOMA-IR均高于活产组（P＜0.05）,多因素Logistic回归分析显示高HOMA-IR、高Hcy、高S/D、高RI、染色体异常是RPL患者流产的危险因素（P＜0.05）。ROC曲线分析显示联合Hcy、S/D、RI预测RPL患者流产的曲线下面积（AUC）为0.849,高于单独预测。结论：RPL患者子宫动脉血流参数S/D、RI、PI和血清Hcy水平均增高,高S/D、RI和Hcy与RPL患者胰岛素抵抗以及流产风险增加有关。联合S/D、RI和Hcy可提高RPL流产风险评估效能。     

Detection of moderate hyperhomocysteinemia: Comparison of the Abbott fluorescence polarization immunoassay with the Bio-Rad and SBD-F high-performance liquid chromatographic assays

Summary. The importance of accurate methods for homocysteine measurement has been emphasized. We compared the results obtained with the most commonly used high-performance liquid chromatography (HPLC) assay, and two recently commercially available methods: another HPLC and a fluorescence polarization immunoassay, in plasmas from normo- or hyper-homocysteinemic patients. A significant agreement between the different methods in classifying the results as hyper or normal-homocysteinemia was observed. However, a significant difference between the results was found. Standardization is urgently necessary to improve the concordance of homocysteine determination. Received May 7, 2000 Accepted July 20, 2000     

Methionine Recycling in Brain: A Role for Folates and Vitamin B-12

Abstract: The recycling of methionine via homocysteine was measured in vivo in brain. After constant intravenous infusions (5 h) of both [³H-methyl] methionine and [³⁵S]methionine into rats, the ratios of [³H-methyl]methionine to [³⁵S]methionine in liver, brain and plasma were determined, Similar experiments were performed in rabbits, except that the [³H-methyl]- and [³S]methionine were injected intraventricularly. If the methyl group of methionine was removed with the formation of homocysteine and then replaced by another (unlabeled) methyl group, the specific activity of the [³H-methyl]methionine would decrease more than that of [³⁵S]methionine; i.e., the ratio of [³H-methyl]- to [³⁵S]methionine in the tissue would decline. The results showed that the ratios of [³H-methyl]- to [³⁵S]methionine in liver and brain were less than the same ratio in plasma in the rats. The comparable ratios in the brain and CSF of rabbits were less than the ratio in the injectate. Since brain contains only one enzyme capable of remethylating homocysteine to methionine, the vitamin B-12–dependent methyltetrahydrofolate-homocysteine methyltransferase (EC 2.1.1.13), our results for methionine recycling via homocysteine in brain strongly support the activity of this enzyme in brain in vivo.     

In vivo investigation of homocysteine metabolism to polyamines by high-resolution accurate mass spectrometry and stable isotope labeling

Polyamines are essential polycations, playing important roles in mammalian physiology. Theoretically, the involvement of homocysteine in polyamine synthesis via S-adenosylmethionine is possible; however, to our knowledge, it has not been established experimentally. Here, we propose an original approach for investigation of homocysteine metabolites in an animal model. The method is based on the combination of isotope-labeled homocysteine supplementation and high-resolution accurate mass spectrometry analysis. Structural identity of the isotope-labeled metabolites was confirmed by accurate mass measurements of molecular and fragment ions and comparison of the retention times and tandem mass spectrometry fragmentation patterns. Isotope-labeled methionine, spermidine, and spermine were detected in all investigated plasma and tissue samples. The induction of moderate hyperhomocysteinemia leads to an alteration in polyamine levels in a different manner. The involvement of homocysteine in polyamine synthesis and modulation of polyamine levels could contribute to a better understanding of the mechanisms connected with homocysteine toxicity.     

Nuclear Enrichment of Folate Cofactors and Methylenetetrahydrofolate Dehydrogenase 1 (MTHFD1) Protect de Novo Thymidylate Biosynthesis during Folate Deficiency

Folate-mediated one-carbon metabolism is a metabolic network of interconnected pathways that is required for the de novo synthesis of three of the four DNA bases and the remethylation of homocysteine to methionine. Previous studies have indicated that the thymidylate synthesis and homocysteine remethylation pathways compete for a limiting pool of methylenetetrahydrofolate cofactors and that thymidylate biosynthesis is preserved in folate deficiency at the expense of homocysteine remethylation, but the mechanisms are unknown. Recently, it was shown that thymidylate synthesis occurs in the nucleus, whereas homocysteine remethylation occurs in the cytosol. In this study we demonstrate that methylenetetrahydrofolate dehydrogenase 1 (MTHFD1), an enzyme that generates methylenetetrahydrofolate from formate, ATP, and NADPH, functions in the nucleus to support de novo thymidylate biosynthesis. MTHFD1 translocates to the nucleus in S-phase MCF-7 and HeLa cells. During folate deficiency mouse liver MTHFD1 levels are enriched in the nucleus >2-fold at the expense of levels in the cytosol. Furthermore, nuclear folate levels are resistant to folate depletion when total cellular folate levels are reduced by >50% in mouse liver. The enrichment of folate cofactors and MTHFD1 protein in the nucleus during folate deficiency in mouse liver and human cell lines accounts for previous metabolic studies that indicated 5,10-methylenetetrahydrofolate is preferentially directed toward de novo thymidylate biosynthesis at the expense of homocysteine remethylation during folate deficiency.     

拉萨地区血浆同型半胱氨酸水平与脑梗死的相关性研究

目的：探讨在高原缺氧环境下,研究血浆同型半胱氨酸水平与脑梗死的相关性及临床意义,为高原地区脑梗死的防治提供依据。方法：随机选取西藏自治区人民医院2011年04月-2012年12月入院治疗的急性脑梗死患者166例作为观察组,选择同期就诊的150例健康检查者作为对照组,患者就诊第二日清晨采空腹静脉血送检。血浆同型半胱氨酸水平应用循环酶法测定,分析同型半胱氨酸水平与脑梗死的相关性。结果：观察组患者血浆中同型半胱氨酸水平明显高于对照组,差异显著具有统计学意义（P〈0．01）。结论：高原环境下,高同型半胱氨酸血症是脑梗死的独立危险因素,血浆同型半胱氨酸水平可作为脑血管疾病一级预防的常规检查指标,以及对缺血性脑卒中的指导治疗有重要意义。     

Selenium Levels in First-Degree Relatives of Diabetic Patients

The present study was conducted to evaluate the serum selenium levels in first-degree relatives of diabetic patients (FDR) according to controls. Insulin resistance, serum lipid levels, inflammation markers, and blood pressure were also studied in these patients. Serum levels of selenium in FDR were significantly lower than control group (74.65 ± 5.9 vs 88.7 ± 8.7 μg/dl, p < 0.0001). HsCRP, HOMA-IR, insulin, homocysteine levels were significantly higher in FDR according to the control group (1.32 ± 0.9 vs 0.63 ± 0.4 mg/dL, p < 0.0001; 2.07 ± 0.84 vs 1.51 ± 0.69, p < 0.0001; 9.26 ± 3.8 vs 6.8 ± 2.98 μU/MI, p < 0.0001; 15.7 ± 7.4 vs 11.5 ± 5.1 μmol/L, p < 0.0001, respectively). There was significant correlation between selenium levels and hsCRP (r = − 0.450, p < 0.0001). There was also weak significant correlation also between HOMA-IR and selenium levels (r = −0.227, p = 0.003). There was a correlation between systolic blood pressure and BMI (r = 0.365, p < 0.0001). But there was no correlation between selenium levels and blood pressure or other parameters. HsCRP, HOMA-IR, homocysteine levels in individuals with selenium levels < 80 μg/L (n = 78) was significantly higher than hsCRP HOMA-IR, homocysteine levels in individuals with selenium levels ≥ 80 (n = 91; 1.23 ± 0.98 vs 0.81 ± 0.76 mg/dL, p < 0.003; 1.99 ± 0.88 vs 1.64 ± 0.74, p < 0.005; 15.0 ± 7.6 vs 12.9 ± 5.7 μmol/L, p < 0.049, respectively). Selenium deficiency may contribute to cardiovascular disease risk in FDR.