心房颤动合并脑栓塞患者血浆同型半胱氨酸的水平及其与CHA_2DS_2-VASc评分的关系  

The level of homocysteine in atrial fibrillation and stroke patients and its correlation with CHA_2DS_2-VASc scores

作　　者：姚艳[1] 赵靖华[1] 冯莉[1] 杜昕[1] 尚美生[1] 董建增[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中国心脏起搏与心电生理杂志》2015年第3期221-223,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：北京市科技新星计划(编号2011081);国家自然科学基金项目(编号81200141)

摘　　要：目的检测同型半胱氨酸(Hcy)在心房颤动(简称房颤)合并脑栓塞患者中的水平,并探讨其临床意义。方法连续入选2013年1月至2014年6月收入本院心内科房颤中心的住院患者,其中房颤合并脑栓塞患者48例,单纯房颤患者85例。选取同期入院的窦性心律患者作为对照组(80例)。空腹采集静脉血,循环酶法按试剂盒标准流程检测血浆Hcy的浓度。依据CHA2DS2-VASc评分系统,计算每位患者的CHA2DS2-VASc评分。结果三组患者在心血管危险因素方面无明显差异性(P>0.05)。与对照组[(9.6±1.7)μmol/L]相比,房颤组的Hcy浓度明显增高(P<0.01),且房颤合并脑栓塞组[(16.2±2.8)μmol/L]显著高于房颤组[(12.5±2.2)μmol/L,P<0.01]。Hcy与CHA2DS2-VASc积分之间呈现明显的正性相关关系(γ=0.33,P<0.01)。结论房颤合并脑栓塞患者血浆Hcy水平显著增高,且与CHA2DS2-VASc积分呈明显的正相关。Objective To examine the level of homocysteine in atrial fibrillation and stroke patients and to explore its correlation with CHA2 DS2-VASe scores. Methods To consecutively enroll the in-patients in our Atrial Fibrillation Department from January 2013 to June 2014, including 48 atrial fibrillation and stoke patients and 85 atrial fibrillation only patients. Eighty patients with sinus rhythm were used as control. The fasting venous blood was collected on empty stomach at early morning, then the concentration of homocysteine was tested according to standard procedures of the diagnostic kit. The scores were measured according to the CHA2DSE-VASc system. Results There were no significant differences in cardiovascular risk factors among three groups （P〉0.05）. Compared to the control[ （9.6±1.7）μmol/L ], the concentration of homocysteine was significantly higher in atrial fibrillation patients（ P〈0.01 ）, furthermore, it was much more higher in atrial fibrillation and stoke patients[ （ 16.2±2.8 ） μmol/L] than in atrial fibrillation only ones[ （12.5±2.2） μmol/L,P〈0.01 ]. There was a positive correlation between homocysteine levels and CHA2 DS2-VASe scores（ γ = 0.33, P〈0. 01 ）. Conclusion The level of homocysteine is significantly increased in atrial fibrillation and stroke patients, and it has a positive correlation with CHA2 DS2 -VASe scores.

关 键 词：心血管病学 同型半胱氨酸 心房颤动 脑栓塞 CHA2DS2-VASc评分 

分 类 号：R541.75[医药卫生—心血管疾病] R743.33[医药卫生—内科学]