血同型半胱氨酸在慢性肾脏病患者中的应用价值

目的研究血清同型半胱氨酸(Hcy)在慢性肾脏病(CKD)中的应用价值。方法选取2016年-2017年在本科住院的209例CKD患者为研究对象,测量收缩压、舒张压、胆固醇、甘油三酯、钙、磷、碱性磷酸酶、超敏C-反应蛋白、Hcy、胎球蛋白A,计算eGFR,测定患者肱踝脉搏波传导速度(ba PWV)。结果从CKD 1期到5期,随着eGFR的下降,Hcy逐渐增高,Hcy与肾功能减退和肾小球滤过率呈负相关(P<0.01)。Hcy与baPWV有一定的相关性(r=0.2290,P<0.01)。Hcy与年龄、收缩压、舒张压、血清胆固醇、甘油三酯、钙磷乘积、碱性磷酸酶、C-反应蛋白呈正相关(P<0.05),与胎球蛋白A呈负相关(P<0.05)。结论Hcy不仅是慢性肾脏病进展的独立危险因素,还是慢性肾脏病患者动脉硬化的重要危险因素,与碱性磷酸酶、胎球蛋白A等动脉硬化相关因素也有一定相关性。

Application value of blood homocysteine in patients with chronic kidney disease

Objective To study the value of serum homocysteine(Hcy)in chronic kidney disease(CKD).Methods A total of 209 CKD patients hospitalized in our department from 2016 to 2017 were selected.Systolic blood pressure,diastolic blood pressure,cholesterol,triglyceride,calcium,phosphorus,alkaline phosphatase,hypersensitive C-reactive protein,Hcy,fetuin-A were measured,eGFR was calculated,and brachial ankle pulse wave velocity(baPWV)was detected.Results HCY increased gradually with the decrease of eGFR from CKD 1 to CKD 5,and Hcy was negatively correlated with renal failure and glomerular filtration rate(P<0.01).There was a certain correlation between Hcy and ba PWV(r=0.2290,P<0.01).Hcy was positively correlated with age,blood pressure,serum cholesterol,triglyceride,calcium×phosphorus,alkaline phosphatase,and C-reactive protein(P<0.05),and negatively correlated with fetuin-A(P<0.05).Conclusion Hcy is not only an independent risk factor of chronic kidney disease,but also an important risk factor for atherosclerosis in patients with chronic kidney disease.It is also correlated with other related factors of atherosclerosis.