The Analysis Of Plasmic Homocysteine,folic Acid And Vitamin B₁₂ In Patients With Chronic Atrophic Gastritis

Objective To observe the characteristics of plasmic homocysteine?Hcy?,folic acid and vitamin B₁₂ in patients with chronic atrophic gastritis?CAG?,and investigate the effect of folic acid and vitamin B₁₂ on Helicobacter pylori?Hp?-positive CAG.Methods 67 cases of HP-negative CAG and 70 cases of non-CAG were diagnosed by urea-13 C breath test or rapid urease test.Electron gastroscopy and gastric mucosal biopsy were used to analyze the plasmic Hcy,folic acid and vitamin B₁₂ characteristics of the two groups.Hp-negative CAG patients were divided into control group?n=35?and treatment group?n=32?according to the treatment.The control group was given conventional therapy;the treatment group was given conventional therapy combined with folic acid,vitaminB₁₂.The levels of plasmic folic acid,vitaminB₁₂,endoscopic mucosal morphology and gastric mucosal biopsy were compared before and after treatment for 24 weeks.Results?1?There was no significant difference in the scores of age,sex,folic acid,vitaminB₁₂,endoscopic histomorphology and histopathological biopsy between the control group and the control group before treatment?P>0.05?.?2?The levels of plasmic Hcy,folic acid and vitaminB₁₂ in Hp negative CAG group and non-CAG group showed that the levels of plasmic Hcy,folic acid and vitaminB₁₂ in Hp negative CAG group were?31.70±10.79umol/L,1.83±0.84ng/ML,118.74±24.30pg/mL?,non-CAG group?19.56±3.84 umol /L,8.73 ± 2.92ng/mL,322.93±103.26pg/mL?,Hp-negative CAG group plasmic Hcy level higher than non-CAG group,While plasmic folic acid and vitaminB₁₂ were significantly lower than those in non-CAG group,and there was significant difference between the two groups?P<0.05?.?3?The scores of mucosal morphology and histopathological biopsy?inflammation,activity and atrophy?in the control group and the treatment group were significantly higher than those in the control group?P<0.05?;Gastric mucosal histopathological biopsy?intestinal metaplasia,atypical hyperplasia?no significant difference?P>0.05?.Conclusions?1?The levels of plasmic folic acid and vitaminB₁₂ in Hp negative CAG group were significantly lower than those in non-CAG group,and plasmic Hcy was significantly higher than that of non-CAG group,suggesting that plasmic folic acid and vitamin B₁₂ could affect the level of Hcy in vivo.?2?Oral folic acid,vitaminB₁₂ can improve the Hpnegative CAG plasmic folic acid,vitaminB₁₂ levels,endoscopic gastric mucosal histomorphology and pathological biopsy?inflammation,activity,atrophy?,and no improvement in intestinal metaplasia and atypical hyperplasia.?3?Hp-negative CAG patients with conventional treatment combined with folic acid,vitaminB₁₂ effect is better than conventional treatment,and can be used as a CAG clinical adjuvant therapy.