慢性肾脏病患者同型半胱氨酸水平与动脉粥样硬化相关性研究

目的探讨慢性肾脏病患者同型半胱氨酸水平与动脉粥样硬化的相关性。方法回顾性分析186例慢性肾脏病患者的临床资料,采用荧光偏振免疫分析法检测血清同型半胱氨酸水平,测定颈动脉内膜中层厚度,按照简化的MDRD方程,估算出肾小球滤过率(eGFR),根据eGFR将CKD患者分为3组:A组eGFR≥60mL/(min.1.73m2);B组eGFR 15～59mL/(min.1.73m2);C组eGFR<15mL/(min.1.73m2)。以同期健康体检病人作为对照组。分析同型半胱氨酸与颈动脉内膜中层厚度(IMT)、颈动脉粥样斑块的相关性。结果慢性肾脏病患者同型半胱氨酸、颈动脉内膜中层厚度均较对照组明显升高(P<0.05),颈动脉内膜中层厚度(IMT)高的病人血浆同型半胱氨酸水平升高(P<0.05)。结论慢性肾脏病患者血浆同型半胱氨酸水平与动脉粥样硬化病变有密切关系,可能是慢性肾脏病动脉粥样硬化的危险因素。

Relationship between homocysteine level and atherosclerosis in patients with chronic kidney disease

Objective To investigate the relationship between homocysteine and atherosclerosis in patients with chronic kidney disease(CKD).Methods One hundred and eighty six CKD patients and 58 healthy volunteers were involved in the study,the level of plasma total homocysteine(Hcy) was determined by fluorescence polarization immunoassay.Intima-medical thickness(IMT) of extracranial common carotid artery was detected,according to abbreviated MDRD formula,all CKD patients were divided to 3 groups: A group eGFR≥60 mL/min·1.73 m2;B group eGFR 15-59 mL/min·1.73 m2;C group eGFR<15 mL/min·1.73 m2.Results Level of Hcy,Intima-medial thickness of extracranial common carotid artery were significantly higher than those in the healthy control and increased in the progresssion of renal insufficiency(P<0.05).The level of Hcy was higher in thick IMT patients(P<0.05).Conclusion Plasma homocysteine has a close relation with carotid atherosclerotic plaque,and the high level of homocysteine may be the risk factor of chronic kidney disease atherosclerosis.