维持性血液透析患者同型半胱氨酸与左心室结构和功能的关系

Relationship between homocysteic acid and left ventricular structure and function of maintenance hemodialysis patients

目的探讨维持性血液透析(MHD)患者同型半胱氨酸与左心室结构和功能的关系。方法选择我院MHD患者58例(血透组)、体检中心30例健康体检者(对照组),检测两组受试者血浆总同型半胱氨酸(tHcy)浓度,用彩色多普勒超声测定左心室舒张末期内径(LVDd)与容积(LVVd)、左心室收缩末期内径(LVDs)与容积(LVVs)、左心室后壁厚度(LVP-WT)、室间隔厚度(IVST)、左心室射血分数(LVEF)、左心室质量指数(LVMI)及舒张早期、晚期最大血流比(E/A),分析tHcy与上述各参数间的关系。结果血透组患者血浆tHcy浓度、LVDd、LVDs、IVST、LVPWT、E/A、射血分数(EF)和LVMI均明显高于对照组,差异有统计学意义(P<0.01);tHcy水平与LVD、IVST、LVMI呈显著正相关,与EF、E/A呈显著负相关。结论 MHD患者存在高同型半胱氨酸血症,tHcy浓度可作为心脏左心室肥厚和功能减退的预测因子。

Objective To evaluate the relationship between homocysteic acid（HCA） and left ventricular structure and function of maintenance hemodialysis（MHD）patients.Methods We selected 58 cases of MHD patients as test group and 30 cases of health controls.Plasma total homocysteine（tHcy）was tested.Left ventricular end diastolic dimension（LVDd）,left ventricular end-diastole volume（LVVd）,left ventricular end-systolic dimension（LVDs）,left ventricular end-systolic volume（LVVs）,left ventricular posterior wall thickness（LVPWT）,interventricular septal thickness（IVST）,left ventricular ejection fraction（LVEF）,left ventricular mass index（LVMI）,and ratio of early diastolic flowvelocity and late diastolic flow velocity（E/A）were tested by color Doppler ultrasound.The relationship between tHcy and the above-mentioned parameters was analyzed.Results The tHcy concentration,LVDd,LVDs,IVST,LVPWT,E/A,EF and LVMI in test group were significantly higher than those in control group（P0.01）.The tHcy level was positively correlated to LVD,IVST and LVMI,and negatively correlated to EF and E/A.Conlusion For MHD patients with high HCA,tHcy concentration can be used as a predictor for left ventricular hypertrophy and left ventricular dysfunction.