H型高血压合并阻塞性睡眠呼吸暂停低通气综合征的观察

目的:探讨H型高血压与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相互关系。方法:选择2013年10月至2014年8月在上海市浦南医院心内科就诊的78例高血压住院患者,血浆同型半胱氨酸(Hcy)水平≥10μmol/L为H型高血压、血浆Hcy水平10μmol/L为单纯性高血压。两者分别用便携式睡眠监测仪(PMD)检测,比较两组结果的差异。结果:H型高血压组的呼吸暂停低通气指数(AHI)高于单纯性高血压组(P0.05),H型高血压组的OSAHS发病率与单纯组无差异(P0.05),在有OSAHS的高血压病人中,H型高血压组有较高的中重度OSAHS的发病率(P0.01)。结论:在高血压患者中,没有发现血浆Hcy水平与OSAHS相关。但是一旦存在OSAHS,则合并H型高血压患者中出现中重度OSAHS的概率较高。     

血浆Hcy、FIB及hs-CRP水平与脑梗死严重程度及复发的相关性分析

目的:探讨血浆同型半胱氨酸(Hcy)、血浆纤维蛋白原(FIB)及超敏C反应蛋白(hs-CRP)水平与脑梗死严重程度及复发的关系。方法:回顾性分析本院收治的138例急性脑梗死患者的临床资料,应用神经功能缺损程度量表对患者脑梗死程度进行评定,监测血浆Hcy、FIB、hs-CRP水平,随访1年,分析以上各指标水平与脑梗死严重程度及复发的关系。结果:轻度、中度和重度脑梗死患者Hcy、FIB及hs-CRP水平比较差异均有统计学意义(P0.05);严重程度与Hcy、FIB及hs-CRP水平呈正相关性(r=0.51、0.43、0.39,P0.05);复发者FIB及hs-CRP水平均显著高于未复发者,比较差异有统计学意义(P0.05)。结论:血浆Hcy、FIB及hs-CRP水平越高脑梗死越严重,且脑梗死复发患者FIB及hs-CRP的水平显著上升,临床应紧密检测指标,尽早治疗以防止病情进一步恶化。     

不同类型脑卒中患者血清同型半胱氨酸水平检测的临床意义

目的:检测不同类型脑卒中患者血清中同型半胱氨酸(Hcy)浓度,探究其临床意义。方法:将2011年2月至2014年10月期间入我院接受治疗的140例脑卒中患者纳入本次研究,作为研究组,其中包含64例脑梗死患者(CI组)、42例脑出血患者(CH组)以及34例短暂性脑缺血发作患者(TIA组),同时以同期135例体检健康者作为对照组。采用循环酶法测定所有研究对象血清Hcy水平,同时采用放射免疫法对其血清内维生素B12、叶酸浓度进行测定。结果:研究组血清Hcy浓度高于对照组,组间差异显著(P0.05);研究组的叶酸及Vit B12低于对照组,组间差异均有统计学意义(P0.05);两组年龄、TC、TG、LDL-C等指标在组间存在差异(P0.05),两组HDL-C差异无统计学意义(P0.05)。CI组、CH组、TIA组血清Hcy水平均高于对照组,差异均有统计学意义(P0.05),但在CI组、CH组、TIA组三组相互对比中,组间差异无统计学意义(P0.05)。进展性脑梗死组血清内Hcy浓度高于完全性脑梗死组,组间数据具有显著差异(P0.05)。不同NIHSS评分患者血清内Hcy浓度不同,评分越高,Hcy浓度越高,两者呈显著正相关关系(P0.05)。回归性相关分析,脑卒中发病危险因素为高Hcy、高总胆固醇、高LDL-C、低叶酸、低Vit B12(P0.05)。结论:脑卒中患者与健康人群血清Hcy水平存在差异,不同类型脑卒中血清Hcy水平存在差异,且血清中同型半胱氨酸水平与脑卒中发病存在相关性,因此可以将血清Hcy作为脑卒中预测、诊断及预后判断的重要指标之一。     

Effects of S‐adenosylhomocysteine and homocysteine on DNA damage and cell cytotoxicity in murine hepatic and microglia cell lines

Limited research has been performed on S‐adenosylhomocysteine (SAH) or homocysteine (Hcy)‐evoked cell damage in hepatic and neuronal cells. In this study, we assessed effects of SAH or Hcy on cell cytotoxicity and DNA damage in hepatic and neuronal cells and attempted to find the underlying mechanism. Cell cytotoxicity and DNA damage were evaluated in murine hepatic cells (BNL CL.2 cell line) and microglia cells (BV‐2 cell line) with SAH or Hcy treatment for 48 h. The influences of SAH or Hcy on lipid peroxidation and DNA methylation were also measured in both cell lines. SAH (5–20 μM) or Hcy (1–5 mM) dose dependently inhibited cell cytotoxicity and enhanced DNA damage in both types of cells. Furthermore, SAH treatment markedly increased intracellular SAH levels and DNA hypomethylation, whereas Hcy caused minimal effects on these two parameters at much higher concentrations. Hcy significantly induced lipid peroxidation, but not SAH. The present results show that SAH might cause cellular DNA damage in hepatic and microglia cells by DNA hypomethylation, resulting in irreversible DNA damage and increased cell cytotoxicity. In addition, higher Hcy could induce cellular DNA damage through increased lipid peroxidation and DNA hypomethylation. We suggest that SAH is a better marker of cell damage than Hcy in hepatic and microglia cells. © 2009 Wiley Periodicals, Inc. J Biochem Mol Toxicol 23:349–356, 2009; Published online in Wiley InterScience ( www.interscience.wiley.com ). DOI 10.1002/jbt.20298     

Boron deprivation decreases liver S-adenosylmethionine and spermidine and increases plasma homocysteine and cysteine in rats

Two experiments were conducted with weanling Sprague–Dawley rats to determine whether changes in S-adenosylmethionine utilization or metabolism contribute to the diverse responses to boron deprivation. In both experiments, four treatment groups of 15 male rats were fed ground corn-casein based diets that contained an average of 0.05 mg (experiment 1) or 0.15 mg (experiment 2) boron/kg. In experiment 2, some ground corn was replaced by sucrose and fructose to increase oxidative stress. The dietary variables were supplemental 0 (boron-deprived) or 3 (boron-adequate) mg boron/kg and different fat sources (can affect the response to boron) of 75 g corn oil/kg or 65 g fish (menhaden) oil/kg plus 10 linoleic acid/kg. When euthanized at age 20 (experiment 1) and 18 (experiment 2) weeks, rats fed the low-boron diet were considered boron-deprived because they had decreased boron concentrations in femur and kidney. Boron deprivation regardless of dietary oil increased plasma cysteine and homocysteine and decreased liver S-adenosylmethionine, S-adenosylhomocysteine, and spermidine. Plasma concentration of 8-iso-prostaglandin F_2α (indicator of oxidative stress) was not affected by boron, but was decreased by feeding fish oil instead of corn oil. Fish oil instead of corn oil decreased S-adenosylmethionine, increased spermidine, and did not affect S-adenosylhomocysteine concentrations in liver. Additionally, fish oil versus corn oil did not affect plasma homocysteine in experiment 1, and slightly increased it in experiment 2. The findings suggest that boron is bioactive through affecting the formation or utilization of S-adenosylmethionine. Dietary fatty acid composition also affects S-adenosylmethionine formation or utilization, but apparently through a mechanism different from that of boron.     

同型半胱氨酸对内皮细胞一氧化氮合酶系统的损伤机制及叶酸的拮抗效应

本实验探讨同型半胱氨酸(Hcy)对人脐静脉内皮细胞(HUVEC)一氧化氮合酶(eNOS)的损伤机制及叶酸(FA)的拮抗效应。HUVEC原代培养,传至第3代后,将其与不同浓度Hcv(10μmol/L、30μmol/L、100μmol/L和300μmol/L)、FA(100μmol/L)或两者联合共同培养72h,用RT-PCR和免疫组织化学技术分别估测细胞eNOS mRNA水平及eNOS蛋白质量;高效液相色谱测定细胞内不对称二甲基精氨酸(ADMA)含量;并分别测定二甲基精氨酸二甲胺水解酶(DDAH)、eNOS活性及一氧化氮(NO)含量。HUVEC与不同浓度Hcy培养72h后,eNOS mRNA和蛋白质表达皆受到抑制;eNOS活性降低;NO生成减少。同时,DDAH活性降低;细胞内ADMA含量呈剂量依赖性增加。加入FA后,eNOS蛋白质水平上调;eNOS活性增强;NO生成增多。同时,DDAH活性增强,ADMA蓄积减少;但eNOS mRNA表达没有改变。Hcy对内皮细胞eNOS的损伤机制涉及eNOS酶蛋白和eNOS的基因表达两个层面,其对eNOS酶蛋白的抑制机制可能通过DDAH-ADMA通路,FA可拮抗Hcy对eNOS酶蛋白的抑制作用,显示出对HHcy有一定的保护作用。但FA对HHcy所导致的eNOS基因表达的抑制无保护效应。     

脑梗死患者同型半胧氨酸与血脂相关性的研究

目的：研究脑梗死患者空腹血浆总同型半胱氨酸（THCY）水平及其与血脂的关系。方法：观察组（54例）均为我院2002年1月．2006年5月住院脑梗死患者,测定空腹THCY水平及血脂各参数;另有同龄健康者为对照组（39例）,进行比较分析。结果：观察组与对照组比较,空腹THCY水平差异有统计学意义（P〈0．05）,血浆HCY含量与TC、TG、HDL-C、LDL-C含量的相关性均无统计学意义。结论：高HCY血症与血脂无关,是脑梗死的独立危险因素之一。     

高血压人群中超敏C反应蛋白、尿酸及同型半胱氨酸水平与臂踝脉搏波传导速度关系的研究

目的:探讨高血压人群中超敏C反应蛋白(hs-CRP)、尿酸(UA)及同型半胱氨酸(Hcy)水平与臂踝脉搏波传导速度(bapwv)的关系。方法:选取2018年1月～2019年12月本院收治的78例高血压患者为研究对象,根据bapwv检测结果将患者分为bapwv正常组及bapwv升高组。采用单因素及多因素Logistic回归分析bapwv异常升高的影响因素。采用Pearson检验对hs-CRP、UA、Hcy与bapwv的相关性进行分析。结果:78例高血压患者中有41例出现bapwv异常升高,发生率为52.56%。经单因素分析显示,bapwv升高组与bapwv正常组患者在性别、年龄、体质指数(BMI)、吸烟史、饮酒史、高血压病程方面对比均无统计学差异(P0.05),bapwv升高组患者的收缩压(SBP)、舒张压(DBP)、hs-CRP、UA、Hcy水平均高于bapwv正常组患者(P0.05)。经多因素Logistic回归分析显示,SBP、DBP、hs-CRP、UA、Hcy均是bapwv异常升高的独立危险因素(OR=1.309、1.193、1.416、1.309、1.205,P0.05)。经Pearson相关分析显示,高血压人群的hs-CRP、UA、Hcy均与bapwv呈正相关(r=0.488、0.510、0.493,P0.05)。结论:hs-CRP、UA、Hcy均是高血压人群bapwv异常升高的独立危险因素,并均与bapwv呈正相关。     

血清同型半胱氨酸及超敏C反应蛋白水平与老年原发性高血压患者颈动脉粥样硬化程度的关系研究

目的:探讨血清同型半胱氨酸(Hcy)及超敏C反应蛋白(hs-CRP)水平与老年原发性高血压患者颈动脉粥样硬化程度的关系。方法:选择我院于2015年5月至2017年10月收治的141例老年原发性高血压患者作为研究对象。检测所有患者颈动脉内膜-中层厚度(IMT),并根据IMT将其分为正常组(IMT≤1.0 mm,n=28)、增厚组(1.0 mmIMT1.5 mm,n=53)和斑块组(IMT≥1.5 mm,n=60)。比较三组患者血清Hcy、hs-CRP、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平,采用Pearson相关分析四项指标与IMT的相关性,采用多元线性逐步回归分析IMT增厚的影响因素。结果:增厚组与斑块组血清Hcy、hs-CRP、TC、LDL-C水平均明显高于正常组,且斑块组血清Hcy、hs-CRP、TC、LDL-C水平明显高于增厚组,差异具有统计学意义(均P0.05)。Pearson相关分析结果表明,血清Hcy、hs-CRP、TC、LDL-C水平均与IMT呈正相关关系(r=0.775、0.836、0.492、0.415,均P0.05)。多元线性逐步回归分析结果显示,血清Hcy、hs-CRP均为IMT增厚的独立危险因素(OR=5.689、7.381,均P0.05)。结论:老年原发性高血压患者颈动脉粥样硬化程度与血清Hcy、hs-CRP关系密切,临床上检测其Hcy、hs-CRP水平可在一定程度上评估颈动脉粥样硬化程度。