充血性心力衰竭患者血浆同型半胱氨酸水平及临床意义

Clinical Significance of Plasma Homocysteine Level in Congestive Heart Failure

目的探讨充血性心力衰竭患者血浆同型半胱氨酸水平及其临床意义。方法106例充血性心力衰竭住院患者,其中40例为心力衰竭初诊患者,66例为心力衰竭复诊患者,除常规生化、超声心动图检查外,测定血浆同型半胱氨酸水平,并与30名健康者比较。结果66例心力衰竭复诊患者血浆同型半胱氨酸水平为(13.25±5.45)μmol/L,明显高于30名健康者的(7.52±1.73)μmol/L(P<0.01);而40例心力衰竭初诊患者血浆同型半胱氨酸水平为(14.87±5.22)μmol/L,更高于健康者(P<0.01)。相关性分析发现,血浆同型半胱氨酸水平与左室舒张、收缩末期内径呈正相关,与左室射血分数呈负相关(P<0.05)。结论充血性心力衰竭患者的血浆同型半胱氨酸水平升高,提示血浆同型半胱氨酸可能在心力衰竭发展中起重要作用。

Objective To examine the relationship between plasma homocysteine level and status of congestive heart failure. Methods Plasma homocysteine level was determined in 106 patients with congestive heart failure （CHF）. Among them, 40 patients were diagnosed as having recent onset of CHF（group 1 ） and the remaining 66 were receiving conventional treatment（group 2）. Thirty healthy subjects were served as a control group. Results The plasma homocysteine levels in group 1, group 2 and the control group were （ 14.87± 5.22 ）, （ 13.25 ± 5.45） and （7.52± 1.73）μmol/L, respectively. The plasma homocysteine level was significantly higher in group 1 and group 2 than in the control group （P 〈 0.01 ）. In the patients with CHF, plasma homocysteine level correlated positively with left ventricular end-diastolic and end-systolic velum, and was inversely related to ejection fraction（P 〈0.05）. Conclusion Plasma homocysteine level increases in patients with CHF and may coiatribute to the progression of CHF.