慢性心力衰竭患者血清同型半胱氨酸、高密度脂蛋白和高敏肌钙蛋白T水平与心功能的相关性研究  

The Relevant Study between the Serum Homocysteine,High-density Lipoprotein,High-sensitivity Cardiac Troponin T and Cardiac Function in Patients with Chronic Heart Failure

作　　者：马云霞[1] 张俭[2] MA Yunxia;ZHANG Jian(Dept of VIP,the First People＇s Hospital of Yinchuan,Yinchuan 750001;Clinical Laboratory,the First People＇s Hospital of Yinchuan,Yinchuan 750001)

机构地区：[1]宁夏银川市第一人民医院VIP科,银川750001 [2]宁夏银川市第一人民医院检验科,银川750001

出　　处：《宁夏医科大学学报》2018年第4期424-428,共5页Journal of Ningxia Medical University

摘　　要：目的观察慢性心力衰竭(chronic heart failure,CHF)患者血清同型半胱氨酸(homocysteine,Hcy)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、高敏肌钙蛋白T(High sensitivity cardiac T,HscTnT)等指标的变化,分析其与患者心功能的关系和血清学诊断价值。方法选取2013年2月-2016年8月我院心内科收治的CHF住院患者200例,设为观察组,并根据美国心脏病协会(NYHA)心功能分级分为Ⅱ级、Ⅲ级、Ⅳ级3个亚组,另选取同期健康体检者100例,设为对照组。采用全自动生化检测仪检测各组患者血清Hcy、HDL-C、Hs-cTnT水平,超声心动图检查测定左室射血分数(left ventricular ejection fractions,LVEF),采用Pearson线性相关分析CHF患者血清Hcy、HDL-C、Hs-cTnT水平与心功能分级和LVEF的相关性。结果与对照组比较,观察组患者血清Hcy与Hs-cTnT水平升高,HDL-C水平降低(P<0.05或<0.01);观察组患者LVEF低于对照组(P<0.05)。观察组不同心功能分级患者血清Hcy、HDL-C、Hs-cTnT水平比较差异均有统计学意义(P<0.05);Pearson相关分析显示,观察组患者血清HDL-C水平与心功能分级呈负相关,与LVEF呈正相关(P<0.05),血清Hcy、Hs-cTnT水平与心功能分级呈正相关,与LVEF呈负相关(P<0.05),观察组患者血清HDL-C水平与血清Hcy和Hs-cTnT水平均呈负相关(P<0.05或<0.01)。结论 CHF患者Hcy与HscTnT水平增高,HDL-C水平降低。其血清水平与患者心功能及心功能损伤程度密切相关,可作为CHF患者早期诊断、治疗和病情评估的参考指标。Objective To observe the changes of the serum homocysteine（Hcy）,high density lipoprotein cholesterol（HDL-C）and high-sensitivity cardiac troponin T（Hs-cTnT）,and to study the correlation between the serum Hcy,HDL-C,Hs-cTnT and cardiac function in patients with chronic heart failure. Methods Total200 patients with chronic heart failure who were admitted to our hospital from February 2013 to August 2016 were selected as the chronic heart failure group and divided into 3 subgroups of class Ⅱ,class Ⅲand class Ⅳ according to the heart function classification of the American Heart Association（NYHA）. And 100 cases of healthy physical examination in the same period were selected as the control group. The levels of serum Hcy,HDL-C,Hs-cTnT were detected by automatic biochemical detector,and the left ventricular ejection fraction（LVEF）was determined by Echocardiography. the correlation between Hcy,HDL-C,Hs-cTnT of the serum and the grade cardiac function and LVEF was analyzed by the Pearson linear correlation analysis in CHF patients. Results Compared with the control group,the levels of serum Hcy and Hs-cTnT in the observation group were increased,and the level of HDL-C decreased significantly（P〈0.05 or 〈0.01）,and the LVEF in the observation group was lower than that of the control group（P〈0.05）. The levels of serum Hcy,HDL-C and Hs-cTnT in the observation group were statistically significant（P〈0.05）. The Pearson correlation analysis showed that the level of serum HDL-C was negatively correlated with the classification of cardiac function,and positive correlation with LVEF（P〈0.05）,and the levels of Hcy and Hs-cTnT in serum were positively correlated with heart function classification and negatively correlated with LVEF（P〈0.05）. Serum HDL-C level in the observation group was negatively correlated with serum Hcy and Hs-cTnT levels（P〈0.05 or〈0.01）.Conclusion The levels of serum Hcy and Hs-cTnT increased and HDL-C decreased in the chronic heart failure patients.Th

关 键 词：慢性心力衰竭 同型半胱氨酸 高密度脂蛋白 心功能 高敏肌钙蛋白T 

分 类 号：R541.6[医药卫生—心血管疾病]