肾功能、血液流变学与高同型半胱氨酸血症的相关性分析

Correlation between renal function,hemorheology and hyperhomocysteine

目的探讨肾功能、血液流变学检测对高同型半胱氨酸血症(HHcy)诊断的应用价值。方法选取505例住院患者,按照同型半胱氨酸(Hcy)水平分为HHcy组120例、非HHcy组385例,比较2组一般临床资料,通过χ^2检验和多因素Logistic回归分析,探讨2组高尿酸、糖尿病、高血压的发病情况。结果HHcy组CREA、BUM、UA水平高于对照组(P<0.05)。HHcy组全血黏度切变率、血浆黏度、红细胞聚集指数、红细胞刚性指数、红细胞变形指数均高于非HHcy组(P<0.05);HHcy患者发病率较高(23.8%)与肾功能异常发病率(24.8%)相当,多因素Logistic回归分析结果显示肾功能异常、高尿酸血症、高血压是HHcy的影响因素(P<0.05)。经叶酸和VB6纠正治疗后,HHcy组Hcy、血流变参数均有所降低(P<0.05)。结论肾功能异常、高尿酸、高血压是HHcy的影响因素;叶酸和VB6干预治疗能降低Hcy水平,改善血流变参数。

Objective To investigate the clinical significance of multiple indexes such as renal function and hemorheology in hyperhomocysteinemia(HHcy).Methods A total of 505 hospitalized patients were enrolled.According to the level of homocysteine(Hcy),they were divided into the HHcy group(including 120 patients)and the non-HHcy group(including 385 patients).The renal function,hemorheology and other indicators were compared between the two groups.The prevalence of high uric acid,diabetes and hypertension in the two groups was investigated by chi-square test and multivariate Logistic regression analysis.Results The levels of CREA,BUM and UA in the HHcy group were higher than those in the non-HHcy group(P<0.05).Hemorheology of the HHcy group:whole blood viscosity shear rate,plasma viscosity,erythrocyte aggregation index,erythrocyte rigidity index,erythrocyte deformation index were higher than that of the non-HHcy group(P<0.05);the incidence of HHcy patients(23.8%)was comparable to the incidence of renal dysfunction(24.8%).Multivariate Logistic regression analysis revealed that main risk factors for HHcy included abnormal renal function,hyperuricemia,hypertension(P<0.05).After correction treatment of folic acid and VB6,the Hcy level in the HHcy group was significantly decreased(P<0.05),and the hemorheology was decreased(P<0.05).Conclusion Renal function and hemorheology are closely related to HHcy.Patients with HHcy are prone to kidney damage,hyperuricemia,hypertension,and other diseases caused by microcirculatory disorders.Folic acid and VB6 intervention can reduce Hcy levels,improve hemorheology,and provide a clinical basis for treatment.