慢性肾脏病患者血清S-腺苷同型半胱氨酸与心血管并发症的关系  

Relation ship between serum S-adenosylhomocysteine level and cardiovascular complications in patients with chronic kidney disease

作　　者：欧三桃[1] 唐小平[2] 李莹[1] 刘琦[1] 张帆[1] 刘建[1] 

机构地区：[1]泸州医学院附属医院肾病内科,四川泸州646000 [2]泸州医学院附属医院传染与免疫学实验室,四川泸州646000

出　　处：《重庆医学》2013年第6期613-615,共3页Chongqing medicine

基　　金：泸州市科技局资助项目(泸市科函[2011]42号)

摘　　要：目的研究同型半胱氨酸(Hcy)的前体物质———腺苷同型半胱氨酸(SAH)水平与慢性肾脏病(CKD)患者心血管并发症的关系。方法选择CKD患者55例和对照组32例,检测并记录患者心血管并发症,酶连续循环比色法检测血清SAH浓度,酶联免疫吸附测定(ELISA)检测血清Hcy浓度,同时采用全自动免疫分析仪检测血清叶酸、维生素B12浓度。结果 CKD患者血清Hcy及SAH均较对照组明显升高,且SAH升高程度更明显。有心血管并发症者血清SAH水平明显高于无并发症组。多因素逐步logistic回归分析显示,高SAH血症是CKD患者心血管并发症的危险因素。两组血清叶酸和维生素B12水平无明显差异。结论 CKD患者血清SAH水平较Hcy更敏感预测心血管并发症,血清SAH与Hcy水平均与患者的肌酐水平明显相关。Objective To explore the change of S-adenosylhomocysteine （SAH）, the precursor of homocysteine （Hcy）,in patients with chronic kidney disease （CKD） and the relationship between serum SAH level and cardiovascular complications （CVD）. Methods Fifty-five CKD patients and 32 healthy volunteers were included in this study. Serum SAH level was measured by continuous cycle enzyme colorimetric method. Serum Hcy level was measured by ELISA. Serum folate and Vitamin Blz levels were measured by automatic immunity analyzer. Results The mean levels of serum Hcy and SAH in CKD patients were significantly higher than that in the healthy controls, especially SAH. The mean level of serum SAH in CKD patients with CVD was significantly higher than that of patients without CVD. Logistic regression analysis indicated SAH was an independent risk factor for cardiovascular disease in patients with CKD. Levels of folate and vitamin B12 do not differ significantly between groups. Conclusion Serum SAH appears to be a much more sensitive indicator of the cardiovascular complications in patients with CKD than Hcy. Serum SAH and Hcy level are significantly correlated with serum creatinine level in patients.

关 键 词：心血管疾病 慢性肾脏病 S-腺苷同型半胱氨酸 

分 类 号：R692[医药卫生—泌尿科学]