高血压患者同型半胱氨酸与左心室心肌纤维化的相关性  

Correlation between homocysteine and left ventricular myocardial fibrosis in hypertensive patients

作　　者：郑月 马运婷 赵晓莹 赵新湘[1] ZHENG Yue;MA Yunting;ZHAO Xiaoying;ZHAO Xinxiang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,650101

出　　处：《天津医药》2023年第4期395-399,共5页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(82160332);昆医联合专项-重点项目(202201AY070001-097)。

摘　　要：目的 探讨高血压患者同型半胱氨酸(Hcy)水平与心脏磁共振晚期钆强化(CMR-LGE)检测的左心室心肌纤维化程度的关系。方法 选取行心脏磁共振(CMR)检查的高血压患者87例,根据Hcy水平分为正常Hcy组(Hcy≤15μmol/L)40例和高Hcy组(Hcy>15μmol/L)47例。比较2组间心脏参数的差异,Spearman秩相关分析Hcy与晚期钆强化容积百分比(LGE%)的相关性,以及Hcy与其他心脏参数的相关性。结果 高Hcy组左心房前后径(LAD)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室质量(LVM)、左心室质量指数(LVMI)、LGE%高于正常Hcy组,而左心室射血分数(LVEF)低于正常Hcy组(均P<0.05)。所有患者Hcy与LAD、LVEDD、LVEDV、LVESV、LVM、LVMI、LGE%呈正相关(rs分别为0.356、0.332、0.288、0.383、0.338、0.325、0.391,均P<0.01),与LVEF呈负相关(rs=-0.412,P<0.01)。结论 高血压患者高Hcy水平者左室心肌纤维化程度严重,加重左心结构及功能障碍。Objective To investigate the relationship between levels of homocysteine(Hcy)and left ventricular myocardial fibrosis measured by late gadolinium enhancement (CMR-LGE) in hypertensive patients. Methods Eightysevenhypertensive patients who underwent cardiac magnetic resonance (CMR) examination were selected. According to Hcylevel, patients were divided into the normal Hcy group (Hcy≤15 μmol/L, 40 cases) and the high Hcy group (Hcy>15 μmol/L,47 cases). The clinical data of all patients were completed between the two groups. Spearman rank correlation analysis wasused to analyze the correlation between Hcy and late gadolinium enhancement volume percentage (LGE% ), and thecorrelation between Hcy and other cardiac parameters. Results The left atrial diameter (LAD), left ventricular enddiastolicdiameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV),left ventricular mass (LVM), left ventricular mass index (LVMI) and LGE% were significantly higher in the high Hcy groupthan those in the normal Hcy group. The left ventricular ejection fraction (LVEF) was significantly lower in the high Hcygroup than that of the normal Hcy group (P<0.05). Spearman correlation analysis showed that Hcy was positively correlatedwith LAD, LVEDD, LVEDV, LVESV, LVM, LVMI and LGE% (rs were 0.356, 0.332, 0.288, 0.383, 0.338, 0.325, 0.391,respectively, all P<0.01). Hcy was negatively correlated with LVEF (rs=-0.412, P<0.01). Conclusion Hypertensivepatients with high Hcy level have severe left ventricular myocardial fibrosis, resulting in more serious left heart structureand dysfunction.

关 键 词：高血压 高半胱氨酸 心室功能障碍 左 心内膜心肌纤维化症 早期医疗干预 

分 类 号：R544.1[医药卫生—心血管疾病]