H型高血压合并冠心病心力衰竭患者血浆同型半胱氨酸水平及其与肾功能的关系研究  

Relationship between plasma homocysteine level and renal function in patients with H-type hypertension complicated with coronary heart disease and heart failure

作　　者：黄南和[1] 魏锦坤 林润杰[1] 孔倩文[1] HUANG Nan;WEI Jinkun;LIN Runjie;KONG Qianwen(Department of Cardiology,Xiaolan People's Hospital,Zhongshan 528400,China)

机构地区：[1]中山市小榄人民医院心血管内科,广东中山528400

出　　处：《包头医学院学报》2022年第1期17-20,共4页Journal of Baotou Medical College

摘　　要：目的:探讨H型高血压合并冠心病心力衰竭(chronic heart failure,CHF)患者血浆同型半胱氨酸(homocysteine,HCY)水平及其与肾功能的关系研究。方法:选取2018年12月至2020年3月本院收治的126例高血压合并冠心病CHF患者,根据血清HCY水平将患者分为H型高血压(Hcy>10μmol/L,75例)、单纯性高血压(Hcy≤10μmol/L,51例),比较两组NYHA心功能分级、肾功能指标血半胱氨酸蛋白酶抑制剂C(cystatinC,CysC)、血尿素氮(BUN)、肾小球滤过率(eGFR)的差异,并分析不同HCY水平与上述指标的相关性。结果:两组患者NYHA心功能分级比较差异有统计学意义(P<0.05),H型高血压组血CysC、BUN水平高于单纯性高血压组,而eGFR低于单纯性高血压组(P<0.05);H型高血压组不同HCY水平患者NYHA心功能分级及血CysC、BUN水平、eGFR比较差异均有统计学意义(P<0.05),其中血CysC、BUN水平随着HCY水平升高而增高,eGFR随着HCY水平升高而降低;Pearson相关性分析结果显示,Hcy与H型高血压患者NYHA心功能、CysC、BUN均呈正相关(P<0.05),与eGFR呈负相关(P<0.05)。结论:H型高血压合并冠心病CHF患者血清HCY水平与患者心功能和肾功能关系密切,HCY可能成为H型高血压合并冠心病CHF患者心肾功能评估的新型标志物。Objective:To investigate the plasma homocysteine(HCY)level in patients with H-type hypertension complicated with coronary heart disease and heart failure(CHF)and its relationship with renal function.Methods:A total of 126 patients with hypertension complicated with coronary heart disease and CHF admitted to our hospital from December 2018 to March 2020 were selected.According to the serum HCY level,the patients were divided into H-type hypertension(Hcy>10μmol/L,75 cases)and simple hypertension(Hcy≤10μmol/L,51 cases).The differences of NYHA cardiac function classification,renal function indexes such as cystatin C(CysC),blood urea nitrogen(BUN)and glomerular filtration rate(eGFR)were compared between the two groups,and the correlation between different HCY levels and the above indexes was analyzed.Results:There was statistically significant difference in NYHA cardiac function between the two groups(P<0.05).The levels of serum CysC and BUN in the H-type hypertension group were higher than those in the simple hypertension group,while eGFR was lower than that in the simple hypertension group,and the differences were statistically significant(P<0.05).There were statistically significant differences in NYHA cardiac function classification,serum CysC,BUN levels and eGFR among patients with different HCY levels in the H-type hypertension group(P<0.05),while the serum CysC and BUN levels increased with the increase of HCY level,and eGFR decreased with the increase of HCY level.Pearson correlation analysis showed that Hcy was positively correlated with NYHA cardiac function,CysC and BUN in patients with H-type hypertension(P<0.05),and negatively correlated with eGFR(P<0.05).Conclusion:Serum HCY level is closely related to cardiac function and renal function in CHF patients with H-type hypertension and coronary heart disease.HCY may be a new marker for evaluating cardiac and renal function in CHF patients with H-type hypertension and coronary heart disease.

关 键 词：H型高血压 冠心病 心力衰竭 肾功能不全 同型半胱氨酸 

分 类 号：R54[医药卫生—心血管疾病]