摘要
目的探讨甲钴胺、叶酸治疗对2型糖尿病患者血浆同型半胱氨酸(Hcy)及同型半胱氨酸硫内酯解酶(HTase/PON)活性的影响。方法 2型糖尿病患者120例,分为4组,每组30例,组Ⅰ:无干预对照组;组Ⅱ:给予叶酸5 mg 口服,1次/日;组Ⅲ:给予甲钻胺500μg肌注,1次/日;组Ⅳ:给予叶酸5 mg+甲钴胺5004μg肌注,1次/日;治疗2周。结果干预组血浆 Hcy 水平比治疗前均显著下降(P<0.05),分别下降为组Ⅳ37.3%,组Ⅲ21.7%,组Ⅱ14.0%,组Ⅰ 2.8%(F=28.894 P=0.000);血清 HTase/PON 活性均显著升高(均 P<0.05),分别升高为组Ⅳ17.6%,组Ⅱ8.0%,组Ⅲ3.4%,组Ⅰ 2.7%(F=36.100,P=0.000)。结论甲钴胺降低血浆 Hcy 作用显著;联合用药对 Hcy及 HTase/PON 的作用显著优于单独用药。叶酸可能通过其抗氧化特性间接影响 HTase/PON 活性。
Objective To study the effects of methylcobalamin and folic acid treatment on plasma homocysteine （Hcy） level and homocysteine thiolactonase/paraoxonase （HTase/PON） activity in patients with type 2 diabetes mellitus. Methods 120 patients with type 2 diabetes mellitus were randomly divided into four equal groups： Group Ⅰ , receiving no intervention therapy as control group,Group Ⅱ , given folic acid orally （5 mg/d）, Group Ⅲ, receiving intramuscular injection of methylcobalamin （500 μg qd） , and Group iV, treated with methylcobalamin （500μg qd） in addition to folic acid （5 mg/d） . Forty healthy age-matched persons were used as normal controls. Before and 12 weeks after 2-week treatment, plasma total Hcy, vitamin B12, folic acid, and HTase/PON activity were assayed. Results After 12-week treatment the plasma folic acid and methylcobalamin, and Hcy levels decreased and serum HTase/PON activity increased significantly in the three groups receiving intervention treatment （ all P 〈 0. 05 ）. The Hcy level decreased by 2.8% in Group Ⅰ , 14.0% in Group Ⅱ, 37.3% in Group Ⅲ, and 21.. 7% in Group iV respectively （ all P 〈0.01）. The HTase/PON activity increased by 2.7% in Group Ⅰ , 8.0% in Group Ⅱ, 3.4% in Group Ⅲ, and 17.6% in Group iV respectively （ all P 〈 0.05）. Conclusion Methylcobalamin and folic acid treatment alone can decrease the Hcy level and increase the HTase/PON activity in the patients with type 2 diabetes mellitus, and the methylcobalamin and folic acid combination therapy is much more effective. Folic acid may affect the HTase/PON activity through its antioxidant ability.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第4期256-258,共3页
National Medical Journal of China
关键词
糖尿病
半胱氨酸
叶酸
甲钴胺
Diabetes mellitus
Cysteine
Folic acid
Methylcobalamin
