摘要
目的探讨老年巨幼细胞性贫血(MA)患者血清同型半胱氨酸(Hcy)水平与T淋巴细胞亚群的相关性。方法选取2012年1月至2014年12月武装警察部队后勤学院附属医院收治的MA患者150例,根据血红蛋白(Hb)水平分为轻度贫血组(73例,90 g/L≤Hb<110 g/L)和中度贫血组(77例,60 g/L≤Hb<90 g/L)。选择同期健康体检者150例作为对照组。检测各组受试者Hb、Hcy、维生素B12、叶酸的水平以及CD3+T、辅助性T细胞(Th)、抑制性T细胞(Ts)比例和Th/Ts比值。结果轻度贫血组和中度贫血组的Hcy水平[(19.4±2.6)μmol/L和(29.3±6.9)μmol/L]与对照组[(9.6±5.3)μmol/L]相比,显著升高(P<0.05),而Hb、维生素B12、叶酸水平显著降低(P<0.05)。与轻度贫血组相比中度贫血组变化幅度较大(P<0.05)。MA组的CD3+T[(59.2±2.6)%]、Ts[(16.9±2.8)%]与对照组[(67.2±3.7)%、(23.4±3.0)%]相比,其比例显著降低(P<0.01),而Th、Th/Ts显著升高(P<0.01)。MA组患者Hcy与维生素B12和叶酸均呈负相关(r=-0.402,-0.437,P<0.05);Hcy与CD3+T、Ts比例呈负相关(r=-0.610,-0.514,P<0.05),而与Th比例及Th/Ts呈正相关(r=0.479,0.515,P<0.05)。结论老年MA患者血清中高Hcy与机体免疫功能异常具有相关性,并可作为临床诊断及评估病情的一项参考指标。
Objective To observe the relationship of changes of homocysteine and T lymphocyte subgroup in elder patients with megaloblastic anemia（ MA）. Methods A total of 150 patients diagnosed as MA admitted to the Affiliated Hospital of Logistics University of Chinese People＇ s Armed Police Force during Jan. 2012 and Dec. 2014 were divided into two groups according to hemoglobin（ Hb） level： light anemia（ 73 cases,90 g / L ≤ Hb 110 g / L） and moderate anemia（ 77 cases,60 g / L ≤ Hb 90 g / L）. Another 150 healthy people for physical examination during the same period in the hospital were selected as the control group. And the Hb,Hcy,cyanocobalamin（ Vit B12）,folic acid and percentage of CD3＋T,Th,Ts and Th / Ts were observed and analyzed. Results Hcy level of mild anemia group[（ 19. 4 ± 2. 6） μmol / L] and moderate anemia group[（ 29. 3 ± 6. 9） μmol / L ]were significantly higher than the control group[（ 9. 6 ± 5. 3）μmol /L]（ P〈0. 05）,while Hb,Vit B12,folic acid were lower in MA group than the control group（ P〈0. 05）. And similar kind changes were found in moderate anemia subgroup when compared to light anemia group（ P〈0. 05）. Moreover,the percentage of CD3＋T cell[（ 59. 2 ± 2. 6） %] and Ts [（ 16. 9 ± 2. 8） %]of mild anemia group and moderate anemia group were lower than control group [（ 67. 2 ± 3. 7） % and（ 23. 4 ± 3. 0） % ]（ P〈0. 01）,and the percentage of Th cell and the rate of Th/Ts were increased in MA group（ P〈0. 01）. Hcy and Vit B12 and folic acid of MA group were positively correlated（ r =- 0. 402,- 0. 437,P〈0. 05）. Hcy were negatively correlated with CD3＋T,Ts percentage（ r =- 0. 610,- 0. 514,P〈0. 05）,and positively correlated with Th and Th / Ts（ r = 0. 479,0. 515,P〈0. 05）. Conclusion The higher level of Hcy relates to the immune abnormality in elder patients with MA and may be an potential predictor to the diagnosis and prognosis.
出处
《医学综述》
2015年第12期2247-2249,共3页
Medical Recapitulate
