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目的 观察慢性肾衰竭(CRF)患者血浆总同型半胱氨酸(tHcy)的变化,探讨其与心、脑血管疾病的关系。方法 选择CRF患者83例和健康对照组40例,采用荧光偏振免疫分析法(FPIA)测定血浆tHcy浓度,全自动生化分析仪测定甘油三酯(TG)、总胆固醇(ChoL)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)浓度,用多元逐步逻辑回归法分析慢性肾衰并发心、脑血管疾病的相关因子,比较血浆tHcy与血脂的相关性。结果 以正常对照组血浆tHcyx+2s为95％可信度上限,CRF患者高同型半胱氨酸血症的发生率为85.54％;CRF患者血浆tHcy水平[(23.16±10.93)μmol·L-1,n=83]明显高于正常对照组[(7.97±2.89)μmol·L～1,n=40](P<0.01);血液透析(HD)组血浆tHcy水平[(24.12±11.67)μmol·L-1,n=一36]显著高于非透析治疗组[(19.53±8.92)umol·L-1,n=31]和持续性非卧床腹膜透析(CAPD)组[(17.34±5.64)μmol·L～1,n=16](P<0.05);83例CRF患者中伴有心、脑血管疾病者的血浆tHcy水平[(26.72±14.21)μmol·L,n=21]明显高于无此类并发症的患者[(20.51±9.07)μmol·L-1,n=62](P<0.01)。相关分析显示,CRF患者的血浆tHcy水平和部分血脂指标对心、脑血管疾病的发生有显著影响,但血浆tHcy水平与血脂各?
Objective To observe the changes of plasma total homocysteine (tHcy) in patients with chronic renal failure (CRF) and to explore its relationship with cardiovascular and cerebrovascular diseases. Methods Totally 83 patients with CRF and 40 healthy controls were enrolled in this study. Plasma tHcy concentration was measured by fluorescence polarization immunoassay (FPIA). The level of triglyceride (TG), total cholesterol (ChoL), low density lipoprotein (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein AI (ApoAI) and apolipoprotein B (ApoB) Disease-related factors, the comparison of plasma tHcy and lipids. Results The plasma tHcyx + 2s in the normal control group was 95% confidence limit. The incidence of hyperhomocysteinemia in CRF patients was 85.54%. The plasma tHcy levels in CRF patients [(23.16 ± 10.93) μmol·L -1 , n = 83] was significantly higher than that of the normal control group [(7.97 ± 2.89) μmol·L -1, n = 40] (P <0.01); The level of plasma tHcy in hemodialysis group [(24.12 ± 11.67) μmol · L-1 and n = 36 were significantly higher than those in the non-dialysis group [(19.53 ± 8.92) μmol·L-1, n = 31] and the continuous ambulatory peritoneal dialysis group (17.34 ± 5.64 μmol (26.72 ± 14.21) μmol·L, n = 21] were significantly higher in 83 patients with CRF than in those without CRF (20.51 ± 9.07) μmol·L-1, n = 62] (P <0.01). Correlation analysis showed that the levels of tHcy and some lipids in patients with CRF had significant effects on the occurrence of cardiovascular and cerebrovascular diseases, but the levels of plasma tHcy and serum lipids were significantly different