正确认知同型半胱氨酸的临床价值课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,同型半胱氨酸(Hcy)检验进展,南海區人民蔗院赵学暲,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,同型半胱氨酸(Hcy)检验进展,1,同型半胱氨酸(Hcy)简介,最重要的甲基供体,基因的抑制作用,HOOC -CH -CH,-CH-S-CH,蛋氨酸,来源:饮食,必需氨基酸,去路:重新甲基化为蛋氨酸(甲硫氨酸),NH,转硫化途径,结合成胱硫醚。,直接释放到细胞外,HOOC -CH-CH,2CH2 SH,同型半胱氨酸,Hooc一cH-cH,半胱氨酸,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,同型半胱氨酸(Hcy)简介,2,同型半胱氨酸(Hcy)的存在形式,浓度(umoL),存在形式,总同型半跳氢酸,型半胱氨酸,(tHcy),同型半胱氨,(疏基形式,在血中主要有一下形势在,检测:总Hy,1.氰化型,加入强还原剂Hcy转化为游,2.还原型,离的还原形式再检测,3.与蛋白共价结合形式,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,同型半胱氨酸(Hcy)的存在形式,3,HCY代谢的关键酶和维生素,THF,蛋氨酸,蛋氨酸,甲基化,MTHFR Methyl,同型半胧氨酸,么,t SAHase,MAT=蛋氨酸腺苷转移,THF=匹氢叶酸,s=蛋氨验合成酶,Methvlene-THF=510亚甲基四氢叶酸,SAHase=S腺苷同型半批氨酸水解酶,丰脱氬酸,Methy L-THF=甲基四氢叶酸,MTHFR=5,10甲基四氢叶酸还原,SAM=S腺苷蛋氨酸,CBS=龇硫能合成,sAH=S腺苷同型半胱氨,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,HCY代谢的关键酶和维生素,4,怀孕,补充吐感,的糖尿病【型),酒精(少呈摄入),您6入),增殖性疾病,糖尿病型,鞭,Bs缺乏,TT. C677TMTHER,与叶酸缺乏联合,餮成酶2(另一种厂的适,1530,100,300,血浆tHcy( mow/L),Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,怀孕,5,Table 3. Determinants of plasma tHcy(for drugs, see Table 4,Heterozygosity for cBs defects,s7,104),Down synd,238),不同疾病状态时,Other polymorphisms,(个),63),Physiologic determinants,Increasing age,(个),ll,e4,94),Male sex,(个),(94,239),66,197),Renal function. re,dGrR(),G8.6,Increasing musc,(个),Lifestyle determinants,Vitamin intake,川50.52,卣王,73,(folate, B12, B6, B2),Smoking,(个),243),Ethanol intake,-246,Exercise,(),(239,247,Clinical conditions,Folate deficiency,(2.116,117),Cobalamin deficiency,(2,117,234),Vitamin Be deficiency,Hyperproliferative disorder,249,250),Hypothyroidism,(251,252),Hyperthyroidism,252,253),Early stage of diabetes,69.254),Late stage of diabetes,254,255),Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,Table 3. Determinants of plasm,6,年龄和性别对HCY的影响,儿童,12岁,名经前女性,男性.40.42岁,经后性,男性,65岁,血浆总同型半胱氢酸 Hmo 1/,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,年龄和性别对HCY的影响,7,影响同型半胱氨酸浓度的药物,抗惊厥药(苯妥英,卡巴咪嗪),甲福明二甲双胍,1氨甲蝶呤:使5-甲基四氢叶酸浓度降低,尼亚新(烟酸,属于钴胺素抑制剂),氧化二氮:使依赖it.B12的蛋氨酸合成酶失活,奥美拉唑以及其他抑制胃酸的药物,贝特类降脂药物,茶碱环孢霉素A,1基化合物(乙酰半胱氨酸,青霉胺),Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,影响同型半胱氨酸浓度的药物,8,冰浴运输、及时分离血浆很重要!,Acid citrate, serum, EDTA, 0oC,Fluoride, heparin, 0C,v- Sodium citrate. 28 C,80,3-Deazaadenasine 25C,3-Deazaadenosine. 25 oC,Fluoride, heparin, 25C,30010- Acd citrate, 25 C,息= Serum.25C,60,EDTA25c,40,0,8,12,RBC释放HcY是主要原因,标本处理,Valadon onry.,ch Asposeslides for NET 4o dient P,alveton o,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,冰浴运输、及时分离血浆很重要!,9,测定变异与生物学变异,口HCY30umoL时,CV可达35%,口检测变异更大,同一标本重复测定更可行,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,测定变异与生物学变异,10,正确认知同型半胱氨酸的临床价值课件,11,正确认知同型半胱氨酸的临床价值课件,12,正确认知同型半胱氨酸的临床价值课件,13,正确认知同型半胱氨酸的临床价值课件,14,正确认知同型半胱氨酸的临床价值课件,15,正确认知同型半胱氨酸的临床价值课件,16,正确认知同型半胱氨酸的临床价值课件,17,正确认知同型半胱氨酸的临床价值课件,18,正确认知同型半胱氨酸的临床价值课件,19,正确认知同型半胱氨酸的临床价值课件,20,正确认知同型半胱氨酸的临床价值课件,21,正确认知同型半胱氨酸的临床价值课件,22,正确认知同型半胱氨酸的临床价值课件,23,正确认知同型半胱氨酸的临床价值课件,24,正确认知同型半胱氨酸的临床价值课件,25,正确认知同型半胱氨酸的临床价值课件,26,正确认知同型半胱氨酸的临床价值课件,27,正确认知同型半胱氨酸的临床价值课件,28,正确认知同型半胱氨酸的临床价值课件,29,正确认知同型半胱氨酸的临床价值课件,30,正确认知同型半胱氨酸的临床价值课件,31,正确认知同型半胱氨酸的临床价值课件,32,正确认知同型半胱氨酸的临床价值课件,33,正确认知同型半胱氨酸的临床价值课件,34,正确认知同型半胱氨酸的临床价值课件,35,正确认知同型半胱氨酸的临床价值课件,36,正确认知同型半胱氨酸的临床价值课件,37,正确认知同型半胱氨酸的临床价值课件,38,正确认知同型半胱氨酸的临床价值课件,39,正确认知同型半胱氨酸的临床价值课件,40,正确认知同型半胱氨酸的临床价值课件,41,正确认知同型半胱氨酸的临床价值课件,42,正确认知同型半胱氨酸的临床价值课件,43,正确认知同型半胱氨酸的临床价值课件,44,正确认知同型半胱氨酸的临床价值课件,45,正确认知同型半胱氨酸的临床价值课件,46,正确认知同型半胱氨酸的临床价值课件,47,正确认知同型半胱氨酸的临床价值课件,48,正确认知同型半胱氨酸的临床价值课件,49,