Paine C J, Hargrove M D, Eichner E R
Arch Intern Med. 1976 Jul;136(7):756-60.
To determine the incidence and importance of folate deficiency in uremia, we studied 41 patients who had chronic uremia but who were not receiving hemodialysis. Serum folate level was assayed by microbiological, whole serum radioassay, and heat-extracted radioassay techniques. Mean serum folate level, as determined with the Lactobacillus casei method, was 6.9 ng/ml (normal, more than 3.0 ng/ml). The mean heat-extracted radioassay serum folate level was 6.6 ng/ml. Only 10% of our patients had subnormal serum folate values, as determined with these techniques. No cases of megaloblastic anemia were discovered, and the hematologic profiles correlated with L casei and heat-extracted radioassay serum folate values. The mean serum folic acid binding protein (FABP) level was significantly greater for the uremic patients than for control patients (26% vs 9.9%, respectively; P = .0005). Our results show that elevated levels of serum FABP spuriously depress the serum folate level, as determined with the whole serum radioassay technique, but apparently do not retard delivery of folate to the tissue in vivo.
为了确定叶酸缺乏在尿毒症中的发生率及重要性，我们研究了41例患有慢性尿毒症但未接受血液透析的患者。采用微生物法、全血清放射分析法及热提取放射分析法测定血清叶酸水平。用干酪乳杆菌法测定的平均血清叶酸水平为6.9纳克/毫升（正常，超过3.0纳克/毫升）。热提取放射分析法测定的平均血清叶酸水平为6.6纳克/毫升。用这些技术测定，我们的患者中只有10%的血清叶酸值低于正常水平。未发现巨幼细胞贫血病例，血液学指标与干酪乳杆菌法及热提取放射分析法测定的血清叶酸值相关。尿毒症患者的平均血清叶酸结合蛋白（FABP）水平显著高于对照患者（分别为26%和9.9%；P = .0005）。我们的结果表明，血清FABP水平升高会使全血清放射分析法测定的血清叶酸水平假性降低，但显然不会阻碍叶酸在体内向组织的输送。
