血清同型半胱氨酸水平变化与原发性高血压肾损伤的关系

目的:探讨血清同型半胱氨酸(Hcy)水平与原发性高血压肾损伤的关系。方法:131例原发性高血压患者根据尿微量白蛋白/肌酐比值(UmAlb/Cr)分为尿蛋白阴性组、微量蛋白尿组和大量蛋白尿组,分别测定Hcy、UmAlb/Cr、胱抑素C(Cys C)和肾小球滤过率(GFR)等指标,并比较各指标与健康对照人群的差异,分析高血压肾损伤患者Hcy水平与肾功能指标UmAlb/Cr、Cys C和GFR的相关性。结果:与健康对照组和尿蛋白阴性组比较,微量蛋白尿组和大量蛋白尿组Hcy及UmAlb/Cr、Cys C明显升高,GFR明显降低,差异均有统计学意义(P0.05,P0.01),尤以大量蛋白尿组更显著(P0.01)。相关性分析显示,Hcy与UmAlb/Cr、Cys C呈显著正相关(r=0.442、0.325,P均0.01),Hcy与GFR呈显著负相关(r=-0.286,P0.01)。结论:Hcy与高血压肾损伤相关,可以作为高血压肾损伤的观察指标之一。

Change of Serum Homocysteine Levels and the Relationship with Primary Hypertensive Renal Damage

Objective：To investigate the relationship between the serum level of homocysteine（Hcy）and kidney damage.Method：According to the urine trace albumin/creatinine ratio（UmAlb/Cr）,the 131patients with primary hypertension were divided into the urine protein negative group,the trace albuminuria group and a large number of proteinuria group.Used as control group,52cases of healthy people were determinated Hcy,UmAlb/Cr,cystatin C（Cys C）and glomerular filtration rate（GFR）and other indicators.And compare the difference between the indexes and healthy control group to analyze Hcy levels in patients with high blood pressure,kidney damage and renal index UmAlb/Cr,Cys C and the correlation of GFR.Results：Compared with healthy controls and urine protein negative groups,trace albuminuria group and a large number of proteinuria Hcy and UmAlb/Cr,Cys C obviously increased,while GFR reduced significantly.The difference was statistically significant（P〈0.01）,which is especially more significant in a large amount of proteinuria group.Correlation analysis showed that Hcy and UmAlb/Cr,Cys C were significantly positive correlated（r=0.442,0.325,P〈0.01）,Hcy and GFR were significantly negative correlated（r=-0.286,P〈0.01）.Conclusion：Hcy is associated with hypertensive renal damage,which can be used as one of observation indexes of hypertensive renal damage.