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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。
Objective: To study the relationship between homocysteine (HCY) and chronic heart failure (CHF) in patients with coronary heart disease. Methods: Fifty-seven CHF patients with coronary heart disease (CHF) were divided into three subgroups according to the NYHA classification of heart function: CHF Ⅱ group, Ⅲ group, and Ⅳ group. Patients with stable coronary heart disease (SAP) ) 20 patients were SAP group; 20 healthy people as healthy control group. Fasting blood samples were taken from all subjects on the morning of the hospital day for determination of homocysteine (HCY) and NT-proBNP. Results: ① The HCY concentration in CHF group was significantly higher than that in SAP group, and both were higher than those in healthy control group. ②CHF group with CHF grade increased, HCY levels gradually increased. The increase of HCY in patients with CHF was positively correlated with the increase of NT-proBNP (r = 0.583, P <0.05). ④ There was a negative correlation between HCY and left ventricular ejection fraction in CHF patients (r = -0.482, P <0.05), and a positive correlation with left ventricular end diastolic diameter (r = 0.561, P <0.05). Conclusion: Hyperhomocysteinemia is associated with coronary heart disease (CHF).