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目的 探讨双相Ⅰ型障碍躁狂发作患者血清同型半胱氨酸(Hcy)水平及其影响因素.方法 采用病例对照研究方法.选取符合美国精神障碍统计与诊断手册第4版(DSM-Ⅳ)诊断标准的住院双相Ⅰ型障碍躁狂发作患者(患者组)73例和健康对照者(对照组)39例.采用用循环酶法测定检测血清Hcy水平,用杨氏躁狂量表(YMRS)评定患者的躁狂症状.结果 血清Hcy水平在患者组[(16.89± 14.67)μmol/L]和对照组[(10.61±6.46) μmol/L]之间差异具有统计学意义(P＜0.01),且男性患者血清Hcy水平[(20.42±16.52) μmol/L]显著高于女性患者[(10.87±8.02) μmol/L] (P＜0.01).患者组高同型半胱氨酸血症发生率(35.6％)显著高于对照组(13.5％)(P＜0.05).相关分析显示体质量指数(BMI)与血清Hcy水平呈正相关(r=0.317,P＜0.05).逐步多元回归分析显示性别、BMI对血清Hcy水平有明显影响(均P＜0.05).结论 双相Ⅰ型障碍躁狂发作患者血清Hcy水平升高,并与性别、BMI有关.“,”Objective To explore the association between serum levels of homocysteine (Hcy) and relation factors in the patients with manic episodes of bipolar Ⅰ disorder(BD).Methods The case-control study was used for this study.A total of 73 inpatients with manic episodes of BD(patient group) and 39 healthy individuals (control group) were enrolled.Diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM-Ⅳ) criteria.Serum levels of Hcy was measured by enzymatic cycling assay.Young Mania Rating Scale(YMRS) were used to assess the severity of clinical symptoms of patients.Results There was a statistical difference in serum Hcy levels between patient group ((16.89± 14.67)μmol/L) and control group ((10.61±6.46) μmol/L) (P＜0.01),and serum Hcy levels was higher in men((20.42± 16.52) μmol/L) than that in women((10.87±8.02) μmol/L) in patients group(P＜0.05).The prevalence rate of high Hcy was 35.6％ in the patient group and 13.5％ in the control group(P＜0.05).Correlation analysis showed body mass index(BMI) had positive correlation with serum levels of Hcy (r=0.317,P＜0.05).Stepwise multiple regression analysis showed male,BMI were associated with serum levels of Hcy among the patients (all P＜ 0.05).Conclusion Serum Hcy levels in the patients with manic episodes of bipolar Ⅰ disorder increase,and it is associated with gender and BMI.