摘要
目的研究血清同型半胱氨酸（HCY）与慢性心力衰竭（CHF）患者血液高凝状态的相关性。方法选择CHF患者105例，依据纽约心脏病协会心功能的分级标准分为三个亚组：心功能Ⅱ级组42例，心功能Ⅲ级组35例，心功能Ⅳ级组28例，纳入同期健康体检者40例作为对照组。入院24 h内分别抽取四组空腹静脉血检测HCY、定量纤维蛋白原（Fbg）、抗凝血酶Ⅲ（AT-Ⅲ）、D二聚体（DDI）、N端B型利钠肽原（NT-proBNP）进行分析。结果四组入选者中Fbg、DDI、HCY、NT-proBNP随心衰程度的加重而增加，AT-Ⅲ随心衰程度的加重而降低；四组入选者Fbg、DDI、HCY、NT-proBNP、AT-Ⅲ相互比较，除心功能Ⅱ级组与正常组比较差异无统计学意义外（P〉0.05），其余各组之间比较差异均有统计学意义（P〈0.05）。HCY与Fbg、DDI、NT-proBNP呈正相关（r＝0.268，0.295，0.404，P〈0.05），与AT-Ⅲ呈负相关（r＝－0.240，P〈0.05）。结论HCY可作为判断CHF患者血液高凝状态的可靠指标，检测HCY、Fbg、DDI、AT-Ⅲ，对判断CHF患者血栓形成风险及病情轻重有参考价值，进行抗凝治疗可能对减少远期的不良事件有益。
ObjectiveTo investigate the correlation between serum homocysteine （HCY） and chronic heart failure （CHF） hypercoagulable state in patients.MethodsA total of 105 cases of patients with CHF was divided into three groups according to the New York Heart Association （NYHA） classification standard functions： heart functional grade II group （42cases）, cardiac function grade III group （35 cases） and, NYHA class IV group （28cases）. At the same time, 40 healthy individuals were regard as the control group. HCY, fibrinogen （Fbg）, D-dimer （DDI）, HCY, N-terminal pro-brain natriuretic peptide （NT-proBNP） were detected by fasting venous blood samples which were collected within 24 hours after admission.ResultsCompared to the control group, the expression of Fbg, DDI, HCY and NT-proBNP increased, whereas, antithrombin Ⅲ （AT-Ⅲ） was reduced. Fbg, DDI, HCY, NT-proBNP, and AT-Ⅲ were found in all patient cases. Four groups were compared with each other, except for cardiac function Ⅱ group and the normal group had no significant difference between them （P〉0.05）, the difference between both other groups was significantly different （P〈0.05）, HCY had a positive correlation with Fbg, DDI, and NT-proBNP （r=0.268, 0.295, and 0.404, P〈0.05）, and negative correlation with AT-Ⅲ （r=-0.240, P〈0.05）.ConclusionsHCY might be a reliable indicator as a judge of CHF patients with hypercoagulable state, to detect HCY, FBG, DDI, and AT-Ⅲ in CHF patients. It benefits for judging thrombosis risk and determining the severity of the diseases. Anticoagulant therapy might be beneficial to reduce the long-term adverse events.
出处
《中国医师杂志》
CAS
2016年第9期1313-1315,1319,共4页
Journal of Chinese Physician
基金
2015湖南省科学技术厅科省重点研发计划（2015SK2045）
