Abstract：Objective To analyze the levels of serum homocysteine (Hcy), folic acid (FA) and vitamin B12 (Vit B12) and their clinical significance in each stage of chronic kidney disease (CKD). Methods Two hundred and forty CKD patients hospitalized in the 455th Hospital of Chinese PLA were selected as the research objects. According to the CKD staging standard, all patients were classified into the stage I group (n=31), the stage II group (n=39), the stage III group (n=58), the stage IV group (n=40) and the stage V group (n=72); meanwhile, another 50 health examinees were selected as the control group. Serum Hcy, FA and Vit B12 levels and renal function indexes, including serum uric acid (UA), creatinine (Scr) and blood urea nitrogen (BUN), were determined in the five patient group as well as the control group, and the correlation between the above-mentioned three serum indexes and the renal function indexes was analyzed. Results Compared with the control group, the levels of Hcy, UA, Scr and BUN in the five patient groups were all increased significantly (all P<0.05), while the levels of FA and Vit B12 in the five groups decreased significantly (both P<0.05). Hcy was significantly positively correlated with UA, Scr and BUN (P<0.05), while FA and Vit B12 were significantly negatively correlated with UA, Scr and BUN (P<0.05). Conclusion The levels of serum Hcy, FA and Vit B12 are closely related to the staging of CKD and renal function. The above-mentioned three serum indexes can effectively reflect the progression and prognosis of patients with CKD, and have a certain reference value in clinical diagnosis and treatment of CKD.
闫伟,姜静, 汤小山, 付兆强, 杨峻. 血清同型半胱氨酸、叶酸和维生素B12在慢性肾脏病各期中的水平分析和临床意义[J]. 实用预防医学, 2017, 24(5): 620-622.
YAN Wei, JIANG Jing, TANG Xiao-shan, FU Zhao-qiang, YANG Jun. Serum homocysteine, folic acid and vitamin B12 levels and their clinical significance in each stage of chronic kidney disease. , 2017, 24(5): 620-622.
[1] 吴军,王天义,吴小冬. 高同型半胱氨酸血症与慢性肾脏病的相关性研究[J]. 中国现代医学杂志,2016,26(14):103-107. [2] 刘玮琳,孙星,张刚,等. 叶酸、维生素B12治疗对早期糖尿病肾病患者同型半胱氨酸水平的影响[J]. 解放军医药杂志,2014,26(1):75-78. [3] 吴东, 蔡建芳, 陈嘉林. 慢性肾脏病[J]. 中华全科医师杂志, 2012, 11(3): 179. [4] 张益民. 慢性肾脏病的定义及分期[J]. 中国中西医结合肾病杂志, 2004, 5(2): 120-120. [5] 周美文,徐元宏. 慢性肾脏病各期唾液酸、同型半胱氨酸及胱抑素C水平的变化及其临床意义[J]. 东南大学学报(医学版),2016,35(4):565-568. [8] 李顺康,朱俊,樊文,等. 血清同型半胱氨酸检测在冠心病、脑梗死、慢性肾脏病患者中的临床应用[J]. 国际检验医学杂志,2012,33(24):3070. [7] Levi A, Cohen E, Levi M, et al. Elevated serum homocysteine is a predictor of accelerated decline in renal function and chronic kidney disease: a historical prospective study[J]. Euro J I Inter Med, 2014, 25(10): 951-955. [8] Wyatt CM,Spence JD. Folic acid supplementation and chronic kidney disease progression[J]. Kidney Int, 2016, 90(6):1144-1145. [9] Xu X,Qin X,Li Y, et al. Efficacy of folic acid therapy on the progression of chronic kidney disease: the renal substudy of the China Stroke Primary Prevention Trial[J]. JAMA Intern Med,2016,176(10):1443-1450. [10] Pastore A, Noce A, Di Giovamberardino G, et al. Homocysteine, cysteine, folate and vitamin B12 status in type 2 diabetic patients with chronic kidney disease[J]. J Nephrol, 2015, 28(5): 571-576. [11] 翁泽兵,郝钦芳,王莉,等. 慢性肾功能不全患者血清同型半胱氨酸与肌酐的相关性分析[J]. 中国临床医生杂志,2014,42(1):65-67.
2017, Vol. 24 
