血同型半胱氨酸水平与冠心病慢性心衰严重程度的相关性分析

目的:观察同型半胱氨酸（Hcy）水平与冠心病慢性心力衰竭(CHF)严重程度的相关性。方法:连续纳入 CHF 84例,按NYHA分级分为3个亚组:Ⅱ级组（n=36）、Ⅲ级组（n=28）、Ⅳ级组（n=20）；并纳入同期住院的25例无心衰的心绞痛患者（CHD组）作为对照组；分别比较CHF组和CHD组及CHF各亚组间Hcy与氮末端脑钠肽(nt-proBNP)、左室射血分数（LVEF）、左室舒张末直径（LVEDD）的差异及相关性。结果:(1)CHF组患者Hcy水平显著高于CHD组，且Hcy水平随心衰分级的增加而增加,各组间差异有统计学意义（P<0.05）。(2)Hcy与nt-proBNP、LVEDD呈正相关(r= 0.51,P< 0.05; r= 0.43,P< 0.05)，与LVEF%呈负相关(r=-0.42,P< 0.05)。结论:Hcy水平与CHF 的严重程度有关，并且随着心衰分级的增加而增加。

Correlation of severity of chronic heart failure with plasma homocysteine level

O bjective: To observe the correlation between the serum homocysteine（Hcy）level and the severity of chronic heart failure（CHF） in patients with coronary heart diseases（CHD）. Methods: CHF patients (n=84) were chosen continuously as CHF group and other patients diagnosed as angina without CHF (n=25) were chosen at the same time as control group . CHF group was divided again into II-grade subgroup (n=36), III-grade subgroup (n=28) and IV-grade subgroup (n=20) according to NYHA grading method. The differences in levels of Hcy and nt-proBNP were analyzed between CHF group and control group and among all subgroups. The correlations between Hcy and nt-pro BNP, left ventricular ejection fraction (LVEF) , left ventricular end-diastolic diameter(LVEDD) were studied. Results:（1）The serum levels of Hcy in CHF group were higher than those in CHD group，as the increase of NYHA grade, the levels of Hcy increased significantly (P<0.05). (2)The level of Hcy was correlated positively with nt-pro BNP and LVEDD (r=0.51,P<0.05;r=0.43,P<0.05) and correlated negative with LVEF (r=-0.42,P<0.05). Conclusion: The serum Hcy level may reflect the severity of CHF and increase with the severity degree of CHF .