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|本期目录/Table of Contents|

老年冠心病慢性心力衰竭患者血清同型半胱氨酸的变化

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第2期
页码:
228-230
栏目:
临床研究
出版日期:
2010-03-04

文章信息/Info

Title:
Correlation between hyperhomocysteinemia and chronic heart failure secondary to coronary heart disease
作者:
贾如意; 赵洁; 柳翠霞; 苑光盈; 王涛; 虞化鹏
济南市第四人民医院心内科、济南市心血管病研究所，山东 济南 250031
Author(s):
JIA Ru-yi;  ZHAO Jie;  LIU Cui-xia;  YUAN Guang-ying;  WANG Tao;  YU Hua-peng
Jinan Institute of Cardiovascular Disease, Department of Cardiology, Fourth People’s Hospital of Jinan, Jinan 250031, Shandong, China
关键词:
冠状动脉疾病; 心力衰竭; 慢性; 同型半胱氨酸; 氮末端脑钠肽
Keywords:
coronary disease;  chronic heart failure;  homocysteine;  N-terminal portion of brain natriuretic
分类号:
-
DOI:
-
文献标识码:
A
摘要:
目的: 研究同型半胱氨酸（HCY）与冠心病慢性心力衰竭（CHF）的关系。方法: 57例冠心病CHF患者（组），按照心功能NYHA分级分为3个亚组：CHFⅡ级组、Ⅲ级组、Ⅳ级组；选择同期住院的无CHF的冠心病稳定型心绞痛(SAP)患者20例为SAP组；健康者20例作为健康对照组。所有观察对象均于住院次日清晨抽取空腹血测定同型半胱氨酸（HCY）、氮末端脑钠尿肽（NT-proBNP）。结果: ①CHF组患者血HCY浓度显著高于SAP组，且二者均高于健康对照组。②CHF组患者随CHF分级的增加，HCY水平逐步增高。③CHF组患者HCY的增加与NT-proBNP的增加呈正相关（r=0.583，P<0.05）。④CHF患者中HCY与左室射血分数值呈负相关（r=-0.482，P<0.05），与左室舒张末内径呈正相关(r=0.561，P<0.05)。结论: 高同型半胱氨酸血症与冠心病CHF有关。
Abstract:
AIM: To study the correlation between the level of serum homocysteine (HCY) and chronic heart failure (CHF) in patients with coronary heart disease (CHD) and to observe the changes of HCY and CHF after short-term treatment with folic acid and vitamins B6 and B12. METHODS: Fifty seven patients with CHF secondary to CHD (heart failure group) were divided into three subgroups according to NYHA cardiac function classification (coronary heart failure II, III and IV groups). Twenty patients who were diagnosed as having stable angina pectoris without heart failure were selected as CHD control group. Twenty healthy subjects served as control group. The levels of HCY and NT-proBNP were measured. RESULTS: Serum HCY in patients with CHF was higher than in patients with stable angina pectoris and the levels in both CHF group and CHD group were higher than in the healthy control group. In the group with CHF, serum HCY increased with the increase of NYHA cardiac function classification (P<0.05). Serum HCY and NT-proBNP were positively correlated. In the CHF group, serum HCY and EF were negatively correlated but serum HCY and LVEDD were positively correlated. After short-term treatment with folic acid and vitamins B6 and B12, levels of HCY and NT-proBNP decreased. CONCLUSION: HCY is associated with CHF in patients with CHD. Serum HCY may participate in the pathogenesis of CHF and may be one of the independent risk factors for heart failure.

参考文献/References

［1］ Stampfer MJ, Malinow MR. Can lowering homocystein levels reduce cardiovascular risk［J］. N Engl J Med, 1995, 332(5)：3298-3299.

［2］ Vasan RS, Beiser A, DAgostino RB, et al．Plasma homocysteine and risk for congestive heart failure in adults without prior myocardial infarction［J］. JAMA, 2003, 289(10):1251-1257.

［3］ 李秀昌，胡燕燕，张运，等. 血清半胱氨酸水平与冠心病严重程度相关性的探讨［J］． 山东医科大学学报， 2001， 39（4）：301-303.

［4］ Blacher J, Demuth K, Guerin AP, et al. Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease［J］. J Nephrol, 1999, 12(4):248-255．

［5］ Herrmann W. The importance of hyperhomocysteinemia as a risk factor for diseases： an overview［J］. Clin Chem Lab Med, 2001, 39(8):666- 674．

［6］ Herrmann M, Kindermann I, Muller S, et al. Relationship of plasma homocystein with the severity of chronic heart failure［J］. Clin Chem, 2005, 51(8)：1512-1515．

［7］ Cesari M, Zanchetta M, Burlina A, et al. Hyperhomocysteinemia is inversely related with left ventricular ejection fraction and predicts cardiovascular mortality in high-risk coronary artery disease hypertensives［J］. Arterioscler Thromb Vasc Biol, 2005, 25(1):115-121.

备注/Memo

备注/Memo:
收稿日期：2009-2-1.通讯作者：贾如意，教授，主要从事冠心病临床和基础研究Email：jrycardiology@sohu.com
更新日期/Last Update: 2010-03-05