CAJ | 학술논문

目的探讨血清同型半胱氨酸(Hcy)水平与冠心病慢性心力衰竭及其严重程度的相关性及临床意义.方法选取冠心病慢性心力衰竭患者70例(冠心病心力衰竭组),无慢性心力衰竭的冠心病稳定型心绞痛患者30例(冠心病对照组),健康者30例(健康对照组).测定血清Hcy水平和脑钠钛(BNP)浓度,彩超测量左室舒张末期内径(LVEDD)和左室射血分数(LVEF),比较各组血清Hcy水平的差异,观察冠心病心力衰竭患者血清同型Hcy水平与心功能分级、BNP、LVEDD、LVEF的关系.结果 ①冠心病心力衰竭组血清Hcy水平高于冠心病对照组,且两组均高于健康对照组,并随心力衰竭程度加重,血清Hcy水平亦升高,其水平在各心功能亚组间比较差异有统计学意义(P＜0.05).②冠心病心力衰竭组血清Hcy水平与BNP呈正相关(r=0.532,P＜0.05),与左室舒张末期内径呈正相关(r=0.473,P＜0.05),与左室射血分数呈负相关(r=-0.436,P＜0.05).结论冠心病慢性心力衰竭患者血清Hcy水平明显升高且随心力衰竭分级的增加同型半胱氨酸平均水平逐渐增高,与左室射血分数呈负相关,与BNP、左室舒张末期内径呈正相关,是影响冠心病心脏结构和功能的一个危险因素.
목적 탐토혈청동형반광안산(Hcy)수평여관심병만성심력쇠갈급기엄중정도적상관성급림상의의.방법 선취관심병만성심력쇠갈환자70례(관심병심력쇠갈조),무만성심력쇠갈적관심병은정형심교통환자30례(관심병대조조),건강자30례(건강대조조).측정혈청Hcy수평화뇌납태(BNP)농도,채초측량좌실서장말기내경(LVEDD)화좌실사혈분수(LVEF),비교각조혈청Hcy수평적차이,관찰관심병심력쇠갈환자혈청동형Hcy수평여심공능분급、BNP、LVEDD、LVEF적관계.결과 ①관심병심력쇠갈조혈청Hcy수평고우관심병대조조,차량조균고우건강대조조,병수심력쇠갈정도가중,혈청Hcy수평역승고,기수평재각심공능아조간비교차이유통계학의의(P＜0.05).②관심병심력쇠갈조혈청Hcy수평여BNP정정상관(r=0.532,P＜0.05),여좌실서장말기내경정정상관(r=0.473,P＜0.05),여좌실사혈분수정부상관(r=-0.436,P＜0.05).결론 관심병만성심력쇠갈환자혈청Hcy수평명현승고차수심력쇠갈분급적증가동형반광안산평균수평축점증고,여좌실사혈분수정부상관,여BNP、좌실서장말기내경정정상관,시영향관심병심장결구화공능적일개위험인소.
Objective To investigate the relationship between the levels of serum homocysteine (Hcy) and the chronic heart failure(CHF) of coronary heart disease(CHD) and the severity of heart failure.Methods All subjects consisted of 70 patients with chronic heart failure of coronary heart disease(CHDHF group),DCMHF group were divided according to NYHA cardiac function classification.Thirty patients who were diagnosed as stable angina pectoris without chronic heart failure as CHD control group.Thirty healthy subjects as healthy control group.By measuring the levels of Hcy and BNP,determining left ventricular end-diastolic volume (LVEDD) and left ventricular ejection fraction (LVEF).The differences of the levels of Hcy among the groups were compared,and the correlation of serum Hcy with NYHA cardiac function classification,BNP,LVEDD and LVEF were observed.Results ①The serum Hcy level in CHDHF group was higher than that in CHD control group,and both were higher than that in the healthy control group.The serum Hcy level were increased with the NYHA cardiac function classification increasing.The levels of Hcy in the three subgroups according to NYHA cardiac function classification had significant difference(P ＜0.05).②In CHDHF group,the level of Hcy was positively correlated with BNP(r =0.532,P ＜ 0.05) and LVEDD(r =0.473,P ＜ 0.05).Inversely,the level of Hcy was negatively related with LVEF (r =-0.436,P ＜ 0.05).Conclusions The average level of Hcy in CHDHF group was higher than other two control groups.The serum Hcy level is increased with the NYHA cardiac function classification increasing.The level of Hcy is negatively correlated with LVEF and positively correlated with BNP and LVEDD.The level or Hcy is a risk factor that affects cardiovascular structures and functions of CHD.