【摘要】 目的探讨同型半胱氨酸（Hcy）代谢相关血浆指标对年龄相关性白内障（ARC）及其亚型的预测作用。方法收集127例ARC患者及129例健康体检者的血浆样本。全自动生化分析仪检测Hcy水平,酶联免疫吸附试验（ELISA）检测亚甲基四氢叶酸还原酶（MTHFR）活性及叶酸（folate）、维生素B₆（VitB₆）和维生素B₁₂(VitB₁₂)的水平。利用受试者工作特征曲线（ROC）评估单个指标或联合指标对ARC及其亚型的预测价值。结果 （1）ARC组MTHFR活性和叶酸水平显著低于对照组,差异有统计学意义（P<0.05）,Hcy水平显著高于对照组,差异有统计学意义（P<0.05）;（2）ROC曲线显示MTHFR活性、Hcy水平及联合检测对ARC有较高的预测价值,曲线下面积（AUC）依次为0.689、0.689、0.732;预测是否发生皮质型ARC的AUC分别为0.825、0.805、0.855;后囊下型ARC的AUC分别为0.706、0.742、0.811;叶酸对后囊下型ARC有一定预测价值,AUC为0.656。结论监测MTHFR活性、Hcy、叶酸水平的变化对早期预测ARC、皮质型ARC和后囊下型ARC有一定参考价值,联合检测5项指标有助于提高准确性。更多还原

【Abstract】 Objective To investigate the value of parameters of homocysteine（Hcy）metabolism in predicting age-related cataract（ARC）and its subtypes.Methods Totally 127 patients with ARC（ARC group）and 129 healthy people（control group）were enrolled in the study,and homocystine levels of the plasma were detected by an automated assay,while concentrations of MTHFR,folate,vitamin B₆ and vitamin B₁₂ were measured by ELISA.The predictive value of single indicator and combined indicators were assessed by area under the receiver operating characteristics curve（AUC）.Results MTHFR activity and folate levels in ARC group were significantly lower than that in control group（P<0.05）,while Hcy level in ARC group was significantly higher than that in the control group（P<0.05）.The AUC of MTHFR,Hcy and combined detection of five indexes for predicting of ARC were0.689,0.689 and 0.732,and for cortical ARC were 0.825,0.805 and 0.855 respectively,meanwhile the AUC for predicting posterior subcapsular ARC were 0.706,0.742 and 0.811 respectively.The AUC of folate for predicting the posterior subcapsular ARC was 0.656.Conclusion Detection of MTHFR activity,Hcy and folate levels may be useful for early diagnosis of ARC,cortical ARC and posterior subcapsular ARC.Combined detection of five indexes could improve the diagnostic efficiency of ARC and its subtypes.更多还原