摘要
目的探讨早期慢性肾脏病（CKD）血浆同型半胱氨酸（Hcy）水平及其与左心室肥大（LVH）的关系。方法64例早期CKD患者分为3组，即A组[eGFR≥90ml·min^-1·（1．73m^2）^-1]31例；B组[eGFR60～89ml·min^-1·（1．73m^2）^-1]22例；C组[eGFR30～60ml·min^-1（1．73m^2）^-1]11例。另设同期健康体检者25例为对照组（N组）。采用荧光偏振免疫分析法测定血浆Hcy浓度，心脏超声检测左室舒张末期内径（LVDd）、室间隔厚度（IVST）和左室后壁厚度（LVPWT）、左心室心肌质量指数（LVMI）。结果①A组血浆Hcy与N组比较无统计学差异（P〉0．05）；B组和C组血浆Hcy显著高于A组和N组（P〈0．01）；C组血浆Hcy显著高于B组（P〈0．01）。CKD组高Hcy（〉12μmol／L）比例为39．06％，是N组的3．26倍。②A组、B组和C组各期左室质量指数（LV—MI）、左室舒张末期内径（LVDd）、室间隔厚度（IVST）、左室后壁厚度（LVPWT）均较N组显著增加。③血浆Hcy与LVPWT显著正相关（r=0．400，P=0．000），与LVMI、LVDd、IVST无相关性。结论早期CKD即出现高Hcy血症，随肾功能进展而加重；血浆Hcy与早期CKD的左心室肥厚有关。
Objective To explore the level of plasma homocysteine（Hey）and its relationship to left ventrieular hypertrophy（LVH）in early stage of chronic kidney disease（CKD）. Methods Sixty- four patients with early CKD were divided into 3 groups： group A（n = 31, eGFR≥90 ml· min^-1 ）, group Bin = 22,60 ml· min^-1· （1.73 m^2 ）^-1 〈eGFR≤89 min^- 1 · （1.73 m^2 ） ^-1 ], and group C[n = 11,30 ml. rain 1. （1.73 m^2 ） ^- 1〈eGFR≤60 ml· min^- 1. （1.73 m^2 ） ^-1]. Twenty-five healthy volunteers served as group N. Plasma Hey levels were determined by the Abbott IMx immunoassay. LVDd, IVST, LVP- WT and LVMI were measured by color Doppler flow imaging. Results （1）No obvious difference in plasma Hey level was observed between groups A and N（P〉0. 05）, but the plasma Hcy level in groups B and C were significantly higher than those in groups A and N（P〈0. 01 ）. The Hcy level in group C was markedly increased as compared with that in group B （P〈0. 01）. The incidence of hyper- homocysteinemia in early CKD was 39. 06%,3.26 times higher than that in healthy individuals （P〈 0. 01）. （2）Compared with the controls, patients with early CKD had larger LVMI, LVDd, IVST and LVPWT. （3） Plasma Hcy showed a positive correlation with LVPWT （r = 0. 400, P = 0. 000）, but no correlation with LVDd, IVST or LVMI. Conclusions Hyperhomoeysteinemia occurs in early CKD. The level of plasma Hcy is elevated in pace with the deterioration of CKD, and has a positive correlation with LVH.
出处
《临床肾脏病杂志》
2010年第7期308-310,共3页
Journal Of Clinical Nephrology
关键词
肾功能不全
慢性
血浆同型半胱氨酸
肥大
左心室
Renal insufficiency,chronic
Homocysteine,plasma
Hypertrophy, left ventricular
