同型半胱氨酸和高敏C反应蛋白与慢性C反应蛋白与慢性充血性心力衰竭关系的临床研究

目的探讨血浆同型半胱氨酸（Hcy）、高敏C反应蛋白（hs CRP）水平与慢性充血性心力衰竭及其严重程度的关系。方法对59例慢性充血性心力衰竭患者（心力衰竭组，其中心功能Ⅱ、Ⅲ、Ⅳ级者分别为14、29、16例）及29例心功能正常者（对照组）测定Hcy、hs CRP水平, 同时用心脏彩色多普勒超声心动仪测定左心室射血分数（LVEF）和左心室舒张末期内径（LVDD）。采用Spcarman相关分析法分析Hcy、hs CRP水平与LVEF及LVDD的相关性。结果心力衰竭组患者血浆Hcy、hs CRP水平均明显高于对照组，差异有统计学意义心功能Ⅱ级组、心功能Ⅲ级组、心功能Ⅳ级组与对照组Hcy分别为（14.6±1.4）、（19.3±4.5）、（29.6±6.6）（9.4±1.2）μmol/L；hs CRP分别为（4.2±2.2）、（12.6±3.7）、（14.7±2.6）、（3.7±1.4）mg/L；均P＜0.01]，且随心功能分级增加，心力衰竭组患者血浆Hcy、hs CRP水平均明显增高，差异有统计学意义（P〈0.01）。Hcy与心功能分级（r=0.769,P〈0.05）和LVDD（r=0.706,P〈0.05）呈明显正相关，与LVEF呈明显负相关（r=-0.856,P〈0.05）；hs CRP水平与心功能分级（r=0.377,P=0.02）呈明显正相关,与LVDD（r=0.347,P=0.072）和LVEF（r=0.204,P=0.058）无明显相关。结论心力衰竭患者HCY、hs CRP随心力衰竭程度的加重而相应升高，Hcy与心功能分级有良好的相关性，对心力衰竭患者的诊断及预后有较好预测价值。

Effects of homocysteine and high sensitivity C-reactive protein on chronic heart failure

ObjectiveTo investigate the effects of homocysteine（Hcy）and high sensitivity C reactive protein （hs CRP） on chronic heart failure including cardiac function classification, left ventricular diastolic diameter（LVDD）,left ventricular ejection fraction（LVEF）].MethodsThe plasma levels of HCY and CRP were tested in 59 patients with heart failure （heart failure group） and 29 healthy volunteers （control group）. The LVDD and LVEF were detected by colour Doppler ultrasound. Results HCY of heart function Ⅱ group, NYHA Ⅲ group, NYHA Ⅳ group and the control group were （14.6±1.4） μmol/L, （19.3±4.5） μmol/L, （29.6±6.6）μmol/L （9.4±1.2） μmol/L, respectively; hs CRP were （4.2±2.2） mg/L, （12.6±3.7） mg/L, （14.7±2.6） mg/L, （3.7 ± 1.4） mg/L, respectively. The levels of HCY and hs CRP increased with cardiac function. The plasma level of Hcy was positively correlated with the severity of NYHA class （r=0.769,P〈0.05）and LVDD（r=0.706, P〈0.05）, but it was negatively correlated with LVEF（r=-0.856, P〈0.05）. The plasma level of hs CRP was positively correlated with the severity of NYHA class（r=0.377,P=0.02）, but it was not correlated with LVDD （r=0.347, P=0.072）and LVEF（r=0.204, P=0.058）. ConclusionsThe levels of Hcy and hs CRP are increased with severity of NYHA class. The level of Hcy has correlations with the heart function.