CAJ | 학술논문

目的观察外源性补充叶酸及维生素 B12对老年慢性肾衰血透患者血浆同型半胱氨酸（ Hcy）水平的影响。方法选取本院肾内科2012年10月～2014年10月收治的老年慢性肾衰血透患者，随机分为HD治疗组与对照组（每组48例）。 HD治疗组给予叶酸及维生素 B12治疗，治疗前及治疗8周后于早晨空腹采集肘静脉血液分别检测叶酸、维生素B12及同型半胱氨酸（ Hcy）水平；HD对照组不给予上述药物治疗，亦于入组时及8周后同上检测血浆叶酸、维生素B12及同型半胱氨酸（ Hcy）水平。同时选取48例健康人群作为健康对照组。比较三组检测结果及治疗组治疗前后各指标水平的变化。结果 HD治疗组及HD对照组入组时的血浆Hcy水平明显高于健康对照组，差异具有统计学意义（ P ＜0．05），叶酸及维生素B12水平三组比较差异无统计学意义（ P ＞0．05）；HD治疗组患者治疗后的血浆 Hcy水平明显低于治疗前，且叶酸及维生素B12水平高于治疗前，差异具有统计学意义（ P ＜0．05）。结论老年慢性肾衰血透患者均存在较高血浆Hcy水平，患者服用叶酸以及维生素 B12可降低血浆 Hcy水平，可能减少心脑血管并发症发生，提高患者生活质量，值得临床应用推广。
목적관찰외원성보충협산급유생소 B12대노년만성신쇠혈투환자혈장동형반광안산（ Hcy）수평적영향。방법선취본원신내과2012년10월～2014년10월수치적노년만성신쇠혈투환자，수궤분위HD치료조여대조조（매조48례）。 HD치료조급여협산급유생소 B12치료，치료전급치료8주후우조신공복채집주정맥혈액분별검측협산、유생소B12급동형반광안산（ Hcy）수평；HD대조조불급여상술약물치료，역우입조시급8주후동상검측혈장협산、유생소B12급동형반광안산（ Hcy）수평。동시선취48례건강인군작위건강대조조。비교삼조검측결과급치료조치료전후각지표수평적변화。결과 HD치료조급HD대조조입조시적혈장Hcy수평명현고우건강대조조，차이구유통계학의의（ P ＜0．05），협산급유생소B12수평삼조비교차이무통계학의의（ P ＞0．05）；HD치료조환자치료후적혈장 Hcy수평명현저우치료전，차협산급유생소B12수평고우치료전，차이구유통계학의의（ P ＜0．05）。결론노년만성신쇠혈투환자균존재교고혈장Hcy수평，환자복용협산이급유생소 B12가강저혈장 Hcy수평，가능감소심뇌혈관병발증발생，제고환자생활질량，치득림상응용추엄。
Objectives To investigate the effect of exogenous folic acid and vitamin B12 on the level of Hey in elderly chronic renal failure patients with hemodialysis .Methods Elderly hemodialysis patients with chro-nic renal failure treated in the department of Nephropathy of our hospital between October 2012 to October 2014 were selected in this study.Patients were randomly divided into two groups,HD treatment group and HD control group (48 cases for each group).Patients in HD treatment group were treated by folic acid , vitamin B12.The levels of Fasting blood folic acid, vitamin B12 and Hcy were measured before the treatment and eight weeks later.For patients in HD control group, no drugs above were administered while such measurements were conducted when patients were en-rolled in this study and 8 weeks after the enrollment.Meanwhile, 48 healthy individuals were recruited into this study as healthy control group.The testing results were compared between the three groups, both the levels of the three fac-tors before and after the treatment.Results The plasma Hcy level in HD patients was higer than the healthy indi-viduals, and the difference was statistically significant( P <0.05); There is no significant difference of folic acid and vitamin B12 between the three groups.After the treatment, the plasma Hcy level decreased, meanwhile the folic acid and vitamin B12 level increased significantly ( P <0 .05 ) .Conclusions Elevated plasma Hcy level are common in elderly chronic renal failure patients with hemodialysis .Treatment with taking Folic acid and VitB12 could decrese plasma Hcy level and, accordingly,may reduce cardiovascular risk and improve the quality of life of the patients, thus worth to be widely promoted.