血浆同型半胱氨酸在原发性高血压合并心力衰竭中表达变化的相关研究南通市通州区人民医院江苏南通226300［摘要］目的探讨血浆同型半胱氨酸在原发性高血压合并心衰患者屮的表达及影响因素。方法入组2014年4月至2015年5月上海第一人民医院心内科住院治疗的高血压患者125例。其屮原发性高血压合并心衰患者51例(心衰组)，不合并心衰患者74例(对照组)。检测并比较两组患者血浆同型半胱氨酸的表达水平。将血浆同型半胱氨酸与血肌酐、妞素氮、低密度脂蛋G胆固醇、BNP、醛固酮、D-二聚体、叶酸、肾素等指标作相关分析，对影响同型半胱氨酸的因素做多元线性回归分析。结果与对照组比较，心衰组血浆同型半胱氨酸水平［16.8(12.4,23)mmol/L］明显升高。将血浆同型半胱氨酸与肌酐、叶酸等指标进行相关分析，同型半胱氨酸与肌酐(r=0.479,p=0.000)、尿素氮(r=0.371,p=0.000)、尿酸(r=0.439,p=0.001)、低密度脂蛋白胆固醇(r=0.178,p=0.047)、BNP(r=0.278,p=0.002)、醛固酮(r=0.363,p=0.000)呈正相关，与叶酸(r=-0.374,p=0.000)呈负相关。对同型半胱氨酸作多重线性回归分析得出线性回归方程:同型半胱氨酸=保酸×0.225-叶酸×0.342+尿素氮×0.206。结论血浆同型半胱氨酸在原发性高血压合并心衰患者屮明显升高。鉍酸、叶酸、鉍素氮是原发性高血压合并心衰患者同型半胱氨酸水平升高的影响因素。［关键词］同型半胱氨酸，原发性高血压，心力衰竭，尿酸，叶酸【屮图分类号】R345.8【文献标识码】A【文章编号】1001-5213(2016)08-0009-02CorrelationstudyofplasmahomocysteineexpressioninpatientswithprimaryhypertensionandheartfailureSongRong-Rong,WangQian,Meng-WeiDong,LiHong-li,SunYa-Ping,ZhaoHong-Sheng.①DepartmentofIntensiveCareUnit,TongzhouPeople’sHospital,Nantong,JiangsuProvince,226300,China.②DepartmentofCardiology,ShanghaiFirstPeople’sHospital,ShanghaiJiaotong---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---University,Shanghai200080,China.③DepartmentofCardiacultrasound,ShanghaiFirstPeople’sHospital,ShanghaiJiaotongUniversity,Shanghai200080,China.④DepartmentofIntensiveCareUnit,AffiliatedHospitalofNantongUniversity,JiangsuProvince,226300,China.[Abstract]Objective:Toexploretheexpressionandinfluencefactorsofplasmahomocysteineinpatientswithprimaryhypertensionandheartfailure.methods:125patientswithprimaryhypertensionrecruitedfromApril2014toMay2015incardiovasculardepartmentofShanghaifirstpeople'shospitalweredividedintotwogroupsaccordingtowhetherwithheartfailure.51withheartfailureenrolledinheartfailuregroupwhile74enrolledinthecontrolledgroup.Thelevelsofplasmahomocysteineweremeasuredandcomparedbetweenthetwogroups.Correlationanalysisweredonebetweenplasmahomocysteineandserumcreatinine,ureanitrogen,lowdensitylipoproteincholesterol,BNP,aldosterone,D-dimer,folicacid,renin,andthenmultiplelinearregressionanalysisofplasmahomocysteineweredone.Results:Plasmahomocysteine[median(interquartilerange):16.8(12.4,23)mmol/L]washigherinheartfailuregroup.AnditwassignificantlycorrelatedwithCreatinine(r=0.479,p=0.000),ureanitrogen(r=0.371,p=0.000),uricadd(r=0.439,p=0.002),lowdensitylipoproteincholesterol(r=0.178,p=0.047),BNP(r=0.278,p=0.002)，aldosterone(r=0.363,p=0.000)andfolicacid(r=-0.374,p=0.000).MultiplelinearregressionrevealedsignificantassociationsbetweenplasmaHeyandUricacid,folicacid,ureanitrogen.TheregressionequationwasHcy=uricacid×0.225-Folicacid×0.206+ureanitrogen×0.342.Conclusion:Plasmahomocysteineincreasedsignificantlyinpatientswithprimaryhypertensionandheartfailure.Uricacid,folicacid,ureanitrogenwereinfluencefactorsofplasmahomocysteine....
