同型半胱氨酸水平与急性心力衰竭的相关性研究

摘要

目的：探讨血清同型半胱氨酸（homocysteine，HCY）水平的升高与急性心力衰竭（acute heart failure，AHF）及其严重程度的关系。方法70例急性心力衰竭患者和53例健康者测定血清同型半胱氨酸、脑钠肽及行心脏彩超检查。分析HCY的水平与急性心力衰竭症状严重程度、脑钠肽的相关性。结果将心衰组按照症状的严重程度分为中度心力衰竭组及重度心力衰竭组，心力衰竭两组与健康组比较，血清同型半胱氨酸水平及脑钠肽逐步增高，三组之间血清HCY与脑钠肽的差异有显著性。心力衰竭各组患者中血清同型半胱氨酸水平与左心室射血分数（left ventricular ejection fraction，LVEF）呈负相关关系，与左心室舒张末内径（left ventricular end-diastolic dimension，LVEDD）、脑钠肽（brain natriuretic peptide，BNP）呈正相关的关系，差异有显著性。结论血清同型半胱氨酸水平升高与急性心力衰竭的发生及严重程度相关。血清同型半胱氨酸水平与心力衰竭的关系主要表现在与左心室收缩功能降低和左心室扩大相关，而与左心室功能及左心室容积正常的心力衰竭无关。%Objective Discuss the correlation between serum homocysteine (HCY) concentration and the severity of acute heart failure (AHF).MethodThe serum HCY and BNP in seventy acute heart failure (AHF and whole heart failure) patients and the healthy people were measured. Echocardiography was also examined.The HCY and BNP level changes and association between HCY and the severity of symptoms in AHF patients,left ventricular ejection fraction (LVEF) , left ventricular end-diastolic dimension (LVEDD),brain natriuretic peptide (BNP) values.Result The serum HCY in the healthy people ,the moderate AHF group and the severe AHF group were increased with the severity of symptoms . The level of HCY and the plasma BNP in the three groups had significant difference in statistics. In heart failure group, the serum HCY and EF were determined with negative linear correlation; the serum HCY and LVEDD、BNP were determined with negative linear correlation respectively.Conclusion The increased serum HY is associated with the incidence and the severity of acute heart failure. The relationship of the increased serum HCY and acute heart failure is mainly associated with the left ventricular contraction function reduction and the left ventricular enlargement, but is irrelevant with the HF patients of the normal left ventricular function and the normal left ventricular capacity.