CAJ | 학술논문

目的：探讨老年慢性心力衰竭（CHF）患者血清同型半胱氨酸（Hcy）、胱抑素 C的水平及意义。方法选取255例不同心功能分级的老年CHF患者，其中心功能Ⅱ级98例，心功能Ⅲ级87例，心功能Ⅳ级70例，以及同期的76例健康体检者，测定4组受试者的 Hcy、胱抑素 C 及血脂水平，记录超声心动图指标，包括左心室射血分数（LVEF）、左心室舒张末内径（LVEDD）、左心室后壁（LVPW）、室间隔厚度（IVS）等指标，评价心功能分级并进行相关分析。结果正常对照组、不同心功能水平之间 LVEF、LVEDD、LVPW、IVS、Hcy、胱抑素C、血脂水平差异均有统计学意义（P ＜0．05）；Hcy、胱抑素 C 水平与心功能分级呈正相关（r ＝0．249、0．144，P 均＜0．01）；胱抑素 C 与LVEDD、IVS、LVPW均呈正相关关系（r＝0．167，0．114、0．231，P均＜0．05）。结论 Hcy、胱抑素 C水平均与心力衰竭严重程度密切相关，胱抑素C还可能参与心室重构过程，推测 Hcy联合胱抑素C水平可作为判定老年CHF严重程度的参考指标。
목적：탐토노년만성심력쇠갈（CHF）환자혈청동형반광안산（Hcy）、광억소 C적수평급의의。방법선취255례불동심공능분급적노년CHF환자，기중심공능Ⅱ급98례，심공능Ⅲ급87례，심공능Ⅳ급70례，이급동기적76례건강체검자，측정4조수시자적 Hcy、광억소 C 급혈지수평，기록초성심동도지표，포괄좌심실사혈분수（LVEF）、좌심실서장말내경（LVEDD）、좌심실후벽（LVPW）、실간격후도（IVS）등지표，평개심공능분급병진행상관분석。결과정상대조조、불동심공능수평지간 LVEF、LVEDD、LVPW、IVS、Hcy、광억소C、혈지수평차이균유통계학의의（P ＜0．05）；Hcy、광억소 C 수평여심공능분급정정상관（r ＝0．249、0．144，P 균＜0．01）；광억소 C 여LVEDD、IVS、LVPW균정정상관관계（r＝0．167，0．114、0．231，P균＜0．05）。결론 Hcy、광억소 C수평균여심력쇠갈엄중정도밀절상관，광억소C환가능삼여심실중구과정，추측 Hcy연합광억소C수평가작위판정노년CHF엄중정도적삼고지표。
ABSTRACT:Objective To investigate the serum level of homocysteine (Hcy), cystatin C and its clinical significance with different NYHA status on congestive heart failure(CHF)in elderly patients.Methods The study selected 255 CHF patients,including 98 cases of NYHA Ⅱ,87 cases of NYHA Ⅲ,70 cases of NYHA Ⅳ,and 76 healthy persons (normal control group)in the same period entered the study.Hcy,cystatin C and lipid levels of four groups were determined,and echocardiographic indicators of four groups were recorded,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall(LVPW), interventricular septum thickness (IVS)and other indicators to evaluate heart function classification and correlation analysis.Results LVEF,LVEDD,LVPW,IVS,Hcy,cystatin C,serum lipid levels among normal control group and different levels of cardiac function were significantly different(P<0.05);Hcy,cystatin C levels were positively correlated to cardiac function(r =0.249,0.144,P <0.01);Cystatin C was positive correlated with LVEDD,IVS, LVPW(r=0.167,0.114,0.231,P <0.05).Conclusion Hcy,cystatin C levels were closely associated with the severity of heart failure,cystatin C may also be involved in the process of ventricular remodeling,suggesting that Hcy joint cystatin C levels can be set as a judge in elderly CHF severity as reference indexes.