慢性肾脏病患者高同型半胱氨酸血症与左心室肥厚相关性研究

摘要

目的：研究慢性肾脏病（CKD）患者血浆高同型半胱氨酸血症（HHcy）与左心室肥厚（LVH）发生的相关性。方法：回顾性分析本院212例CKD1-5期非透析患者的临床病例，其中血浆高同型半胱氨酸血症组（Hcy group）145例，血浆正常同型半胱氨酸血症组（n-Hcy group）67例，并采用彩色多普勒超声诊断仪测定患者的左心室形态结构。结果：212例CKD1-5期患者中发生左心室肥厚（LVH）者占45.75%，其中血浆高同型半胱氨酸（Hcy）组左心室肥厚发生率为51.03%，血浆正常同型半胱氨酸（Hcy）组左心室肥厚发生率为34.33%，两组比较差异有统计学意义（P<0.01）；且血浆Hcy增高组的室间隔厚度（IVST）、左心室后壁厚度（LVPWT）、左心室心肌重量指数（LVMI）均明显高于血浆Hcy正常组，比较差异有统计学意义（P<0.01）。结论：慢性肾脏病患者普遍存在高同型半胱氨酸血症和左心室肥厚，高同型半胱氨酸血症是慢性肾脏病患者发生左心室肥厚的独立危险因素。%Objective:To study the the relationship between hyperhomocysteinemia and left ventricular hypertrophy in patients with chronic kidney disease. Method:Clinical 212 CKD1-5 non-dialysis patients were analyzed. The serum Hyperhomocystinemia Group(Hcy group)included 145 cases and the serum normal-hyperhomocystinemia Group(n-Hcy group)67 cases. To estimate the ventricular morphology with color doppler ultrasonic diagnostic instrument. Result:45.75%patients had left ventricular hypertrophy(LVH)on the 212 CKD1-5 non-dialysis patients. The probability of the Hcy group was 51.03%,and the n-Hcy group was 34.33%,which was lower than that of the Hcy group(P<0.01). And the level of the interventricular septum thickness(IVST),left ventricular posteriorwall thickness(LVPWT),and left ventricular mass index (LVMI)of the Hcy group was higher than that of the n-Hcy group(P<0.01). Conclusion:Patients with chronic kidney disease is prevalent hyperhomocysteinemia and left ventricular hypertrophy. Hyperhomocysteinemia is an independent risk factor for left ventricular hypertrophy in chronic kidney disease patients.