CAJ | 학술논문

目的比较不同病因大细胞贫血患者血浆同型半胱氨酸(HCY)、叶酸及维生素B12的水平及治疗前后的动态变化,探讨其在鉴别诊断及治疗中的意义.方法测定HCY、叶酸、维生素B12水平使用电化学发光免疫法.全血细胞分析计数采用激光流式细胞检测法(光学法)及电阻抗法.结果营养性巨幼细胞贫血患者HCY为(71.26±27.84)μmol/L,较药物性巨幼细胞贫血(11.44±5.06)μmol/L、骨髓增生异常综合征(9.51±4.13)μmol/L及健康对照组(8.74±5.42)μmoL/L均明显升高(P均<0.01);小剂量叶酸、维生素B12治疗后营养性巨幼细胞贫血患者HCY水平可以恢复至正常,但较大剂量组恢复时间延迟.结论血浆HCY的水平在不同病因大细胞贫血中具有鉴别意义,其恢复时间与应用叶酸及维生素B12剂量相关.
목적 비교불동병인대세포빈혈환자혈장동형반광안산(HCY)、협산급유생소B12적수평급치료전후적동태변화,탐토기재감별진단급치료중적의의.방법 측정HCY、협산、유생소B12수평사용전화학발광면역법.전혈세포분석계수채용격광류식세포검측법(광학법)급전조항법.결과 영양성거유세포빈혈환자HCY위(71.26±27.84)μmol/L,교약물성거유세포빈혈(11.44±5.06)μmol/L、골수증생이상종합정(9.51±4.13)μmol/L급건강대조조(8.74±5.42)μmoL/L균명현승고(P균<0.01);소제량협산、유생소B12치료후영양성거유세포빈혈환자HCY수평가이회복지정상,단교대제량조회복시간연지.결론 혈장HCY적수평재불동병인대세포빈혈중구유감별의의,기회복시간여응용협산급유생소B12제량상관.
Objective To examine the serum homocysteine,folic acid and Vitamin B12 levels in macrocytic anemia patients and observe their dynamic changes following therapy. Methods Homocysteine,folic acid and Vita-min B12 were analyzed by electro-chemiluminescence immunoassay. Complete blood cell count was analyzed by opti-cal method and resistance method. Results The homocysteine is significantly higher in nutritional megaloblastic a-nemia[ (71.26±27.84)μmoL/L ] than in drug-induced megaloblastic anemia[(11.44±5.06)μmol/L],in myel-odysplastic syndrome[ (9.51±4.13)μmol/L] and in the normal control group[(8.74±5.42)μmoL/L] (P<0.01). After treated with low-dosage folic acid and Vitamin B12,the patients with megaloblastic anemia presented slow declining but eventually normal homocysteine levels,compared with those received high-dosages. Conclusion Homocysteine can be used for differential diagnosis of macrocytic anemia. The duration of remaining of abnormal ho-mecysteine levels is related to the dosage of folic acid and Vitamin B12.