内科住院患者的血浆同型半胱氨酸水平及其相关影响因素分析

Study of the plasma homocysteine level and its related factors in medical inpatients

目的描述内科住院患者血浆同型半胱氨酸（Hcy）水平及分布特点,分析Hcy与相关因素的关系。方法横断面调查我院2014年12月~2015年1月住院的262例内科患者。采用酶法检测血浆Hcy水平,使用SPSS 13.0软件对检测指标进行处理。结果内科患者Hcy水平平均值为17.50±9.36μmol/L,与正常参考值15μmol/L比较有显著差异（P=0.000）,其中男性hcy平均水平为19.38±11.06μmol/L,高于女性15.40±6.42μmol/L,男女Hcy均值差异有统计学意义（P=0.001）。使用单样本t检验方法分析神经内科、肾内科、呼吸内科、心血管内科、内分泌科、肿瘤科、消化内科不同专科住院患者Hcy水平,结果显示神经内科和肾内科患者的Hcy平均值高于参考值（15μmol/L）,差异有统计学意义（P〈0.01）。以Hcy为因变量,以年龄及血脂各项指标为自变量,多因素逐步回归分析提示Hcy与高密度脂蛋白间有显著负相关关系（r=-0.263）。结论内科住院患者Hcy平均水平高于正常值,Hcy存在性别差异,神经内科和肾内科患者的Hcy平均水平较高,Hcy水平与血脂中高密度脂蛋白水平成负相关关系,降低Hcy可能成为治疗动脉粥样硬化的靶点之一。

Objectives To analyze the plasma homocysteine（ Hcy） level of 262 medical inpatients and investigate the factors affecting the level of homocysteine. Methods Cross-sectional survey of 262 medical inpatients at the same time in our hospital,their plasma homocysteine and lipid concentrations were measured. Then analyzed the clinical and laboratory data by SPSS 13. 0. Results The Hcy average level of medical inpatients was17. 50 ± 9. 36μmol / L,that was significantly higher than the normal range15. 0μmol / L（ P = 0. 000）. The average male homocysteine was 19. 38 ± 11. 06μmol / L. And the average female homocysteine was 15. 40 ± 6. 42μmol / L. There was a significant difference between males and females（ P = 0. 001）. Our research found the patients of Nephrology and Neurology were more likely to have hyperhomocysteinemia. Stepwise regression analysis showed that the Hcy level correlated with high-density lipoprotein level HDL（ r =- 0. 263）. Conclusions The hcy average level of medical inpatients was higher than normal level. The average male homocysteine was higher than that in females. The patients of Nephrology and Neurology were more likely to have hyperhomocysteinemia. Hcy levels and high-density lipoprotein levels were negatively correlated.