血清同型半胱氨酸水平与老年慢性心力衰竭患者心脏结构和功能的相关性研究

Study on the relationship between serum homocysteine levels and cardiac structure and function in aged patients with chronic heart failure

目的探讨老年慢性心力衰竭患者血清同型半胱氨酸（homocysteine，HCY）的水平及其对心脏结构和功能的影响。方法研究对象为2010年1月-2011年6月上海交通大学附属第一人民医院老年科住院患者，年龄70～94岁，平均（83．5±5．5）岁。包括慢性心力衰竭患者40例，非心力衰竭患者40例，心功能分级采用NYHA分级。血清HCY的水平采用酶联免疫法测定。采用超声心动图仪测定左室后壁厚度、室间隔厚度、左室舒张末内径和左室射血分数。结果老年慢性心力衰竭组血清HCY高于非心力衰竭组伊〈0．05），而且慢性心力衰竭组患者心力衰竭程度随HCY的水平升高而加重（P=0．03）。舒张末期内径与HCY呈正相关（r=0．394，P〈0．05），而左室射血分数与HCY水平呈负相关（F=-0．53，P〈0．01o结论老年慢性心力衰竭患者组血清HCY高于非心力衰竭组。血清HCY是慢性心力衰竭的独立危险因素。

Objective To study the serum homocysteine （HCY） level of aged patients with chronic heart failure and the effects of HCY on cardiac structures and functions. Methods Eighty patients greater than or equal to 65 years old were divided into group with chronic heart failure （CHF） or group without CHF according to NYHA functional class. Serum HCY were measured by enzyme linked immunosorbent assay. Cardiac parameters were measured by echocardiography and calculated by established formulas. Results Serum HCY in aged patients with CHF were higher than those without CHF （P〈0.05）. The cardiac function in patients with CHF was deteriorated with the increasing level of serum HCY. Left ven-tricular end diastolic diameter positively were correlated with HCY （r=0.394, P 〈 0.05）. Left ventricular ejection fraction negatively were correlated with HCY （ r=-0.53, P〈0.01）o Conclusion There is a significant increase of serum HCY levels in aged patients with CHF. HCY is the independent risk factor of cardiac structures and functions.