同型半胱氨酸与冠心病合并2型糖尿病患者心功能的相关性分析

Correlation between Homocysteine and Cardiac Function in Patients with Coronary Heart Disease and Type 2 Diabetes

目的研究同型半胱氨酸(HCY)与冠心病合并糖尿病患者心功能的关系。方法选取92例冠心病合并2型糖尿病患者测定HCY、脑钠肽(BNP),行超声心动图测定左心室射血分数(LVEF),按照美国纽约心脏病学会(NYHA)心功能分级标准分为心力衰竭(HF)组(63例)和无HF组(29例)。HF组又分为3个亚组:HFⅡ级组、HFⅢ级组、HFⅣ级组。结果 HF组患者HCY(19.5±8.0)μmol/L,显著高于无HF组(12.6±4.1)μmol/L,差异具有统计学意义(P<0.01)。HF组患者随心功能NYHA分级的增加,HCY水平逐步增高。HCY水平与心功能分级之间呈正相关(r=0.49,P<0.01),在控制年龄、性别变量后,HCY水平与心功能分级仍呈正相关(r=0.46,P<0.01)。HCY水平与LVEF呈负相关(r=﹣0.30,P<0.05)。HCY水平与BNP水平呈正相关(r=0.39,P<0.01)。结论冠心病合并2型糖尿病患者随心功能恶化,HCY水平逐渐增高。

Objective To explore the correlation between the level of homocysteine （HCY） and cardiac function in patients with coronary heart disease and diabetes. Methods Ninety-two cases of patients with coronary heart disease and diabetes mellitus were divided into heart failure （HF） group （n = 63） and non-heart failure group （29 cases） according to NYHA cardiac function classification. Furthermore,HF group was divided into three sub-groups：HF grade II group,HF grade III group,and HF grade 1V group. The levels of homocysteine （HCY） and brain natriuretic peptide （BNP） were measured. Ultrasound echocardiography were taken to determine left ventricular ejection fraction （LVEF）. Results Serum HCY in HF group （19.5± 8.0）μmol/L was significantly higher than that in the non-HF group（12.6±4.1）μmol/L, and the difference was statistically significant （P〈0.01）. HCY increased with the increase of NYHA cardiac function classification. HCY and heart function grading were positively correlated （r=0.49,P〈0.01）. After age and gender variables were controlled,HCY levels and heart function grading continued to show a positive correlation （r= 0.46,P〈0.01）. HCY and LVEF were negatively correlated （r=-0.30,P〈0.05）. HCY and BNP were positively correlated （r=0.39,P〈 0.01）. Conclusions As heart function deteriorates, HCY levels increase in patients with coronary heart disease and diabetes.