同型半胱氨酸与缺血性心肌病和扩张性心肌病的关系探讨

Distinctive relation of serum homocysteine in patients with ischemic cardiomyopathy and dilated cardiomyopathy

目的:探讨同型半胱氨酸(Hcy)水平变化与缺血性心肌病和扩张性心肌病的关系及意义。方法:选取我院冠心病患者198例,其中缺血性心肌病患者80例(A组),扩张性心肌病患者53例(B组),普通冠心病患者65例(对照组),入选者均行冠状动脉造影。比较三组的一般临床资料。采用酶联免疫法测定并比较三组血清同型半胱氨酸水平,测定相关生化指标。采用彩色多普勒超声诊断仪测定三组左房内径,左室舒末内径及左室射血分数。结果:B组与对照组相比,同型半胱氨酸水平无明显差异,A组同型半胱氨酸水平明显高于对照组(P<0.05),A组同型半胱氨酸水平与B组相比显著增高(P<0.05),A组年龄高于B组及正常对照组(P<0.05)。三组一般临床资料,如糖尿病、血脂、高血压、吸烟饮酒、叶酸、维生素B12水平等方面比较,差异无统计学意义。与对照组相比,A组与B组的左房内径、左室舒末内径明显增大(P<0.05),左室射血分数明显降低(P<0.05)。结论:检测同型半胱氨酸水平在临床上可对鉴别缺血性心肌病和扩张性心肌病提供帮助。

Objective： To study the distinctive relation of changes of level of serum homocysteine（Hcy） in patients with ischemic cardiomyopathy（ICM） and dilated cardiomyopathy（DCM）.Methods： 80 patients with ICM was selected as group A,53 patients with DCM was selected as group B,65 normal cases were selected as control group.Clinical data′s of 3 groups were compared.Hcy of 3 groups were analyzed by enzymoimmunoassay（MAIA）,and biochemical indexes were assayed.Left atrial dimension（LAD）,left ventricular enddiastolic dimension,left ventricular ejection fraction were assayed by diasonograph.Results： There was no difference at Hcy between group B and control group,Hcy of group A was significantly higher than control group（P0.05）,Hcy of group A was significantly higher than group B（P0.05）.The age of group A was higher than group B and control group（P0.05）.There were no difference in clinic dates of 3 groups included smoking,drinking,fat,diabetes,hypertension,folate,Vitamin B12 and so on.LAD and left ventricular enddiastolic dimension of group A and group B were increased than control group（P0.05）.Left ventricular ejection fraction were obviously decrease than control group（P0.05）.Conclusion： Hcy level may help to distinguish DCM and ICM in clinic.