B族维生素治疗肾移植受者高同型半胱氨酸血症.docVIP

B族维生素治疗肾移植受者高同型半胱氨酸血症 作者：赵敬杰 作者单位：山东大学第二医院 【摘要】 目的：探讨叶酸、维生素B6及B12在治疗肾移植患者高同型半胱氨酸（Hcy）血症中的作用。方法：将195例预接受首次肾移植患者随机分为两组：试验组103例，口服叶酸5?mg/d，维生素B6 50?mg/d及维生素B12 1?mg/d，连续2个月左右；对照组92例则未口服B族维生素。分别于服药治疗前、术前1?d、术后1、10、20及30?d检测血浆Hcy浓度和血清肌酐水平。结果：试验组血浆Hcy浓度与对照组相比具有统计学意义（P＜0.000?1），试验组术后血清肌酐水平下降较快，发生急性排斥反应的比例低于对照组。结论：肾移植患者围手术期适当补充叶酸、维生素B6及B12可降低血浆Hcy浓度，有助于移植肾功能的快速恢复，是减少肾移植并发症及急性排斥反应的重要措施。 【关键词】 同型半胱氨酸 维生素类 肾移植 A〖KH+9.2mmD]Effect of vitamin B on hyperhomocysteinemia in renaltransplant recipients ZHAO Jingjie1, LIU Junli1,　TIAN Chuan2,　ZHANG Cai3 （1. Laboratory of Clinical Molecular Biology, Second Hospital of Shandong University, Jinan 250033, Shandong, China; 2. Transplant Center, Second Hospital of Shandong University, Jinan 250033, Shandong, China; 3. Institute of Immunopharmacology and Immunotherapy, School of Pharmacy， Shandong University, Jinan 250012, Shandong, China） ［ABSTRACT］ Objective: To explore the effect of folic acid, Vit B6, and Vit B12 on hyperhomocysteinemia in renaltransplant recipients. Methods: 195 renaltransplant recipients were randomly divided into the vitamin treatment group (group A, n=103, folic acid 5?mg/d, vitamin B6 50?mg/d, Bl2 1?mg/d, totally 2 months) and the control group (group B, n=92)． The plasma Hcy levels were determined before treatment, before operation and 1, 10, 20 and 30 days after operation. Results: The plasma level of Hcy in group B was significantly higher than that in group A before and after operation. The rate of acute rejection was lower in group A than in group B. Conclusion: Vitamin B supplementation can reduce the homocysteine level and the rate of acute rejection for renaltransplant recipients． ［KEY WORDS］ Homocysteine； Vitamins； Kidney transplantation 动脉粥样硬化是慢性肾衰竭的并发症，也是肾移植受者（renaltransplant recipients,RTRs）的主要致死原因［1］。多年研究表明，同型半胱氨酸（homocysteine，Hcy）是一般人群发生心脑血管病的独立危险因子［2］。Hcy是蛋氨酸循环中的一个重要中间产物，叶酸、维生素B6及维生素B12是蛋氨酸代谢的辅助因子，其浓度