血清Hcy水平与慢性肾功能不全分期的关系

The relationship between serum Hcy levels with chronic renal dysfunction in different clinical stages

目的分别检测慢性肾功能不全不同临床分期患者血清同型半胱氨酸(Hcy)水平,探讨血清Hcy与肾功能不全临床分期的关系。方法运用循环酶法测定94例早期慢性肾功能不全患者(早期肾功能不全组)、58例肾功能衰竭患者(肾功能衰竭组)、148例慢性肾功能不全尿毒症期且行血液透析治疗(透析组)、194例健康体检者(对照组),比较各组间的Hcy水平。结果与对照组血清Hcy水平[(13.7±3.6)μmol/L]相比,早期肾功能不全组血清Hcy水平[(23.9±7.4)μmol/L]、肾功能衰竭组血清Hcy水平[(28.1±10.1)μmol/L]、透析组血清Hcy水平[(33.0±12.6)μmol/L]显著升高,差异有统计学意义(P<0.01)。3组患者血清Hcy水平比较,透析组、肾衰竭组、早期肾功能不全组依次降低,差异有统计学意义(P<0.05)。此外,3组患者男性血清Hcy水平均显著高于女性,差异有统计学意义(P<0.05)。结论与对照组比较,慢性肾功能不全者的血清Hcy水平普遍升高,而且随着肾功能损伤的程度加深,Hcy结果也逐渐增高,在肾功能不全尿毒症透析时达到较高的浓度水平,血清Hcy水平可以作为监测慢性肾功能不全病情进展的一个重要指标。

Objective To investigate the relationship between serum homocysteine（Hcy）and renal dysfunction by analyzing serum homocysteine（Hcy）levels of patients with chronic renal dysfunction in different clinical stages.Methods Serum Hcy of 94patients with early chronic renal dysfunction（early renal dysfunction group）,58cases of patients with renal failure（renal failure group）,and the line of 148patients with uremia hemodialysis（hemodialysis group）,194healthy subjects（control group）,were determined using the circulating enzymatic method.The test results were analyzed statistically.Results The serum Hcy values of early renal dysfunction group[（23.9±7.4）μmol/L],renal failure group[（28.1±10.1）μmol/L]and hemodialysis group[（33.0± 12.6）μmol/L],were significantly higher than the control group[（13.7±3.6）μmol/L]（P0.01）.The serum Hcy levels of three groups of patients showed that dialysis group was the highest and early renal dysfunction group was the lowest.The differences of each group were statistically significant（P0.05）.In addition,serum Hcy levels in three groups of male patients were significantly higher than female（P0.05）.Conclusion Compared with control group,serum Hcy levels generally increased in chronic renal insufficiency.Serum Hcy increased gradually as the deterioration of renal function.Therefore,detection of serum Hcy level can be used as an important indicator for monitoring of chronic renal insufficiency progression.