慢性心力衰竭患者血清同型半胱氨酸水平与短期预后的关系研究

目的:探讨慢性心力衰竭患者血清同型半胱氨酸水平与短期预后的关系。方法:选择80例慢性心力衰竭(chronic heart failure,CHF)患者,并选择80例同期体检的健康者纳入对照组,检测血清同型半胱氨酸(homocysteine,Hcy)、N-末端脑钠肽前体(NT-proBNP)水平,并测定左室射血分数(left ventricular ejection fraction,LVEF),比较不同研究对象间血清Hcy、NT-proBNP及LVEF,并比较不同Hcy水平患者的预后。结果:CHF患者血清Hcy为(17.88±4.16)μmol/L,明显高于对照组的(9.62±4.61)μmol/L(P<0.05);CHF患者血清Hcy、NT-proBNP水平随着NYHA心功能分级的升高而增高,LVEF则逐级下降,不同分级间两两比较,差异均有统计学意义(P<0.05);CHF患者血清Hcy与NT-proBNP呈正相关,与LVEF呈负相关(P<0.05);Hhcy组与正常Hcy组MACE发生率比较差异无统计学意义(P>0.05);但正常Hcy组6min步行距离明显长于Hhcy组(P<0.05)。结论:慢性心力衰竭患者普遍存在血清Hcy水平增高,且其水平与心力衰竭严重程度及短期预后有关。

Study of the relationship between serum homocysteine and short term prognosis in patients with chronic heart failure

Objective:To discuss the relationship between serum homocysteine and short-term prognosis of patients with chronic heart failure.Methods:80 cases of patients with chronic heart failure (CHF) were selected,80 cases of health persons for medical examination in our hospital at the same period were selected as the control group,the serum homocysteine (Hcy),N-terminal pro brain natriuretic peptide precursor (NT proBNP) and left ventricular ejection fraction (LVEF) were detected,the serum Hcy,NT-proBNP levels and LVEF were compared,and Hcy levels were compared in the different prognosis patients.Results:The serum Hcy in CHF patients was (17.88-± 4.16) umol/L,and it was significantly higher than that of the control group,which was (9.62 ± 4.61) umol/L (P ＜ 0.05).In CHF patients,the serum Hcy,NT-proBNP rised higher with NYHA class,LVEF was dropped gradually,and there were of statistically significant in different classification (P ＜ 0.05).The serum Hcy was positive with NT-proBNP,and negatively correlated with LVEF (P ＜ 0.05),there showed no statistical significance of MACE rate in Hhcy group and normal Hcy group (P ＞ 0.05),hut 6minute walking distance in normal Hcy group was significantly longer than that of Hhcy group (P ＜ 0.05).Conclusions:The serum Hcy in patients with chronic heart failure is increased,and its level is related to the severity of heart failure and short term prognosis.