同型半胱氨酸与慢性心力衰竭合并肾功能不全的相关性分析

Correlation analysis of homocystein and chronic heart failure combined with insufficient renal function

目的探讨同型半胱氨酸（Hcy）在慢性心力衰竭并肾功能不全患者外周血中的表达。方法选取2013年6月~2014年6月本院心血管内科收治的58例慢性心力衰竭患者作为研究对象,根据患者病情分为慢性心力衰竭合并肾功能不全组（n=28）和慢性心力衰竭组（n=30）。分别予以心脏超声检测左室射血分数（LVEF）,酶联免疫吸附法检测血浆脑钠肽（BNP）水平,酶法检测血浆肌酐水平。结果慢性心力衰竭并肾功能不全组的Ⅲ、Ⅳ级患者所占比例显著高于慢性心力衰竭组,LVEF水平显著低于慢性心力衰竭组,外周血Hcy、BNP水平显著高于慢性心力衰竭组,差异有统计学意义（P〈0.05）。外周血的Hcy水平与BNP水平和肌酐水平呈明显正相关,与LVEF水平呈负相关。结论 Hcy参与了慢性心力衰竭并肾功能不全的发生、发展,可能是慢性心力衰竭并肾功能不全的潜在干预靶点。

Objective To explore the levels of homocystein （Hcy） in patients with chronic heart failure combined insuf-ficient renal function. Methods 58 patients with chronic heart failure in our hospital from June 2013 to June 2014 were selected as the research object.According to patient’s condition,all patients were divided into the chronic heart failure combined insufficient renal function group （n=28） and the chronic heart failure group （n=30）.The left ventricular ejec-tion fraction （LVEF） was determined by cardiac ultrasound,the levels of plasma BNP were determined enzyme-linked immuno sorbent assay,the levels of plasma creatine were determined by enzymatic method. Results The proportion of patients of gradeⅢ and gradeⅣ in chronic heart failure and renal insufficiency group was higher than that in chronic heart failure group,the level of LVEF in chronic heart failure and renal insufficiency group was lower than that in chronic heart failure group,the levels of BNP and Hcy in peripheral blood of chronic heart failure and renal insufficien-cy group was higher than that in chronic heart failure group,with significant difference （P〈0.05）.The levels of plasma Hcy was positively correlated with the levels of plasma BNP and creatine,but negatively correlated with LVEF. Con-clusion Hcy is participated in the development of chronic heart failure concurrence insufficient renal function,which may be a potential target for patients with chronic heart failure combined renal dysfunction.