摘要
目的探讨血清同型半胱氨酸（Hcy）水平与冠心病慢性心力衰竭及其严重程度的相关性及临床意义。方法选取冠心病慢性心力衰竭患者70例（冠心病心力衰竭组），无慢性心力衰竭的冠心病稳定型心绞痛患者30例（冠心病对照纽），健康者30例（健康对照组）。测定血清Hcy水平和脑钠钛（BNP）浓度，彩超测量左室舒张末期内径（LVEDD）和左室射血分数（LVEF），比较各组血清Hcy水平的差异，观察冠心病心力衰竭患者血清同型Hey水平与心功能分级、BNP、LVEDD、LVEF的关系。结果①冠心病心力衰竭组血清Hcy水平高于冠心病对照组，且两组均高于健康对照组，并随心力衰竭程度加重，血清Hcy水平亦升高，其水平在各心功能亚组间比较差异有统计学意义（P〈0．05）。②冠心病心力衰竭组血清Hcy水平与BNP呈正相关（r=0．532，P〈0．05），与左室舒张末期内径呈正相关（r=0．473，P〈0．05），与左室射血分数呈负相关（r=-0．436，P〈0．05）。结论冠心病慢性心力衰竭患者血清Hcy水平明显升高且随心力衰竭分级的增加同型半胱氨酸平均水平逐渐增高，与左室射血分数呈负相关，与BNP、左室舒张末期内径呈正相关．是影响冠心病心脏结构和功能的一个危险因素．
Objective To investigate the relationship between the levels of serum homocysteine （Hey） and the chronic heart failure （CHF） of coronary heart disease （ CHD ） and the severity of heart failure. Methods All subjects consisted of 70 patients with chronic heart failure of coronary heart dis- ease（ CHDHF group） , DCMHF group were divided according to NYHA cardiac function classification. Thirty patients who were diagnosed as stable angina pectoris without chronic heart failure as CHD control group. Thirty healthy subjects as healthy control group. By measur/ng the levels of Hey and BNP, deter- mining left ventrieular end-diastolic volume （LVEDD） and left ventricular ejection fraction （LVEF）. The differences of the levels of Hcy among the groups were compared, and the correlation of serum Hcy with NYHA cardiac function classification, BNP, LVEDD and LVEF were observed. Results （~）The serum Hcy level in CHDHF group was higher thtm that in CHD control group, and both were higher than that in the healthy control group. The serum Hey level were increased with the N YHA cardiac function classifica- tion increasing. The levels of Hcy in the three subgroups according to NYHA cardiac function classifica- tion had significant difference （ P 〈 0.05 ）. （~）In CHDHF group, the level of Hcy was positively correla- ted with BNP（ r =0.532, P 〈 0.05） and LVEDD（ r = 0.473, P 〈 0.05）. Inversely, the level of Hey was negatively related with LVEF （ r = -0. 436, P 〈 0. 05 ）. Conclusions The average level of Hey in CHDHF group was higher than other two control groups. The serum Hcy level is increased with the NYHA cardiac function classification increasing. The level of Hey is negatively correlated with LVEF and positively correlated with BNP and LVEDD. The level of Hcy is a risk factor that affects cardiovascu- lar structures and functions of CHD
出处
《中国实用医刊》
2013年第10期12-14,共3页
Chinese Journal of Practical Medicine
关键词
冠心病
慢性心力衰竭
血清同型半胱氨酸
Coronary heart disease
Chronic heart failure
Serum homocysteine
