社区中老年居民血浆同型半胱氨酸水平与轻度舒张性心力衰竭的相关性研究

Correlation of plasma homocysteine levels with early mild diastolic heart failure in middle aged and elderly subjects

目的调查社区人群中血浆同型半胱氨酸(homocysteine,HCY)水平与轻度舒张性心力衰竭(diastolic heart failure,DHF)的相关性。方法对浦东新区某社区人群实施横断面调查,比较485例轻度DHF患者(Mild组)和974例非DHF对照组(Normal组)的血浆HCY水平,采用Logistic回归分析方法,分析血浆HCY水平与轻度DHF的关联。结果 Mild组血浆HCY水平显著高于Normal组(13.28±6.93 vs.12.17±7.79,P<0.05),且两组人群中血浆HCY水平在不同象限中的构成比差异具有统计学意义(P<0.05),Logistic回归分析结果显示年龄、心率、血浆HCY水平、E/E'和EF与早期DHF相关。结论 Mild组血浆HCY水平较Normal组升高;年龄增高、心率增快、高血浆HCY水平等因素是早期DHF的独立危险因素,E/E'和LVEF增高为保护性因素。

Objective To study the correlation of plasma homocysteine （HCY） levels with early mild diastolic heart failure （DHF） in middle aged and elderly residents in community. Methods Total 485 middle aged and elderly subjects with early mild DHF （DHF group） and 974 non-DHF subjects （control group） from a community of pudong district were enrolled in the study. The physical examination, blood tests and echocardiography were performed, and the questionnaire survey was also conducted. Results The plasma HCY levels were higher in DHF group than that in control group （13.28 ±6.93 vs. 12.17±7.79,P 〈0.05）. Logistic regression analysis demonstrated that age, heart rate, E/E＇ ratio, EF was independently correlated with early mild DHF. Conclusion The results indicate that increased plasma HCY levels, age and heart rate are risk factors and increased early diastolic transmittal velocity/early diastolic velocity of mitral annulus （E/E＇） ratio and ejection fraction （EF） are protective factors of early mild DHF.