同型半胱氨酸在慢性肾脏病中的研究进展

Research Progress of Homocysteine in Chronic Kidney Disease

摘要: 随着慢性肾脏病(chronic kidney disease, CKD)发病率的逐年增加，CKD已经成为全球性健康挑战，严重影响患者的生活质量及预期寿命。同型半胱氨酸(Homocysteine, Hcy)是日常饮食中甲硫氨酸代谢的中间产物，其代谢平衡受叶酸、B族维生素等辅助因子及基因突变等因素的影响。在CKD患者中可以发现多数患者存在血Hcy水平的升高。高同型半胱氨酸氨酸血症(Hyperhomocysteinaemia, HHcy)近年来一直被认为是CKD患者的一个严重危险因素，同时也是心脑血管疾病(Cardiovascular disease, CVD)的独立危险因素，而CVD是终末期肾病(end-stage renal disease, ESRD)患者死亡的主要原因。合理补充B族维生素、叶酸是控制Hcy水平，预防其相关疾病的有效措施。随着关于Hcy、叶酸、B族维生素与CKD研究的逐渐深入，Hcy与CKD间的关系仍需要更多的研究进一步证实，而叶酸与B族维生素降低Hcy水平对降低CKD患者CVD风险的有效性也尚不明确。本文旨在对目前已发表的Hcy与CKD的相关研究进行综述，以期为CKD的治疗和预防提供参考。

Abstract: With the increasing incidence of chronic kidney disease (CKD) year by year, CKD has become a glob-al health challenge, which seriously affects the quality of life and life expectancy of patients. Homo-cysteine (Hcy) is an intermediate product of methionine metabolism in daily diet. Its metabolic balance is affected by folic acid, B vitamins and other cofactors as well as gene mutations. Elevated Hcy levels can be found in most patients with CKD. Homocysteine acid hematic disease (Hyperho-mocysteinaemia, HHcy) in recent years has always been considered a significant risk factor in pa-tients with chronic kidney disease (CKD), as well as the independent risk factors of cardiovascular diseases (CVD). And CVD is the leading cause of death in patients with end-stage renal disease (ESRD). Reasonable supplement of B vitamins and folic acid is an effective measure to control the level of Hcy and prevent its related diseases. With the gradual deepening of studies on Hcy, folic acid, B vitamins and CKD, the relationship between Hcy and CKD still needs to be further confirmed by more studies, and the effectiveness of folic acid and B vitamins in reducing the risk of CVD in pa-tients with CKD is still unclear. This paper aims to review the published studies on Hcy and CKD, in order to provide reference for the treatment and prevention of CKD.