中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (7): 600-603.doi: 10.12007/j.issn.0258-4646.2017.07.006

• 论著 • 上一篇    下一篇

高同型半胱氨酸血症对慢性稳定性冠状动脉粥样硬化性 心脏病患者肾功能的影响

苏艳红,郑红梅,郭旭,王晓鸥,张新忠,张大庆   

  1. 中国医科大学附属盛京医院心内科,沈阳 110004
  • 收稿日期:2016-12-19 出版日期:2017-07-31 发布日期:2017-07-21
  • 通讯作者: 张大庆 E-mail:zhangdaqing@vip.163.com
  • 作者简介:苏艳红(1990 -),女,医师,硕士 .
  • 基金资助:
    国家自然科学基金(81200199)

Hyperhomocysteinemia Promotes Renal Function Impairment in Patients with Chronic Stable Coronary Artery Disease

SU Yanhong,ZHENG Hongmei,GUO Xu,WANG Xiaoou,ZHANG Xinzhong,ZHANG Daqing   

  1. Department of Cardiology,Shengjing Hospital,China Medical University,Shenyang 110004,China
  • Received:2016-12-19 Online:2017-07-31 Published:2017-07-21

摘要: 目的 研究高同型半胱氨酸血症(HHcy)对慢性稳定性冠状动脉粥样硬化性心脏病(SCAD)患者肾功能的影响及其可能机制。方法 将 100 例 SCAD 患者按其血浆同型半胱氨酸(Hcy)水平分为 HHcy 组(Hcy≥15 μmol/L,n = 53)和对照组(Hcy<15μmol/L,n = 47)。观察肾功能指标与 Hcy 以及血清白细胞介素 6(IL-6)和脂联素(APN)水平的关系。结果 HHcy 组患者血清IL-6 水平较对照组显著升高(P < 0.05),血清 APN 水平较对照组显著下降(P < 0.05)。相关性分析显示,血浆 Hcy 水平与肌酐(r = 0.379,P < 0.001)、尿酸(r = 0.238,P = 0.019)、胱抑素 C(r = 0.513,P < 0.001)及 IL-6(r = 0.561,P < 0.001)呈正相关,而与肾小球滤过率(r = -0.288,P = 0.023)及 APN 水平(r = -0.428,P < 0.001)呈负相关。进一步分析示,IL-6 与肌酐(r = 0.406,P =0.002)、尿酸(r = 0.359,P = 0.007)、胱抑素 C(r = 0.387,P = 0.007)呈正相关,与肾小球滤过率(r = -0.370,P = 0.005)呈负相关;APN 与肌酐(r = -0.694,P < 0.001)、尿酸(r = -0.420,P < 0.001)、胱抑素 C(r = -0.553,P < 0.001)呈负相关,而与肾小球滤过率(r = 0.251,P = 0.034)呈正相关。结论 血浆 Hcy 水平可能对 SCAD 人群肾功能减退具有预测价值。在 SCAD 人群中,血浆 Hcy可能通过引发机体促炎和抗炎机制失衡来加重 SCAD 患者肾功能不全。

关键词: 高同型半胱氨酸血症, 炎症状态, 肾功能不全, 慢性稳定性冠状动脉粥样硬化性心脏病

Abstract: Objective To investigate the possible mechanism of hyperhomocysteinemia(HHcy)in renal dysfunction in patients with chronic stable coronary artery disease(SCAD). Methodse We consequentially enrolled patients diagnosed as having SCAD and,according to homocysteine(Hcy)levels,divided them into the HHcy group(Hcy≥15 μmol/L,n = 53)and control group(Hcy<15 μmol/L,n = 47). We further tested the relationship among plasma Hcy level,renal function,and serum levels of interleukin(IL)-6 and adiponectin(APN). Results IL-6 was significantly higher in the HHcy group than in the control group(P < 0.05). However,APN level was obviously lower in the HHcy group than in the control group(P < 0.05). Correlation analysis revealed that Hcy level positively correlated with creatinine(r = 0.379,P < 0.001),uric acid(r =0.238,P = 0.019),cystatin C(r = 0.513,P < 0.001),and IL-6 levels(r = 0.561,P < 0.001)but negatively correlated with estimated glomerular filtration rate(eGFR;r = -0.288,P = 0.023)and APN level(r = -0.428,P < 0.001). IL-6 level showed positive correlations with creatinine(r =0.406,P = 0.002),uric acid(r = 0.359,P = 0.007),and cystatin C levels(r = 0.387,P = 0.007)but a negative correlation with eGFR(r =-0.370,P = 0.005). Meanwhile,APN level showed negative correlations with creatinine(r = -0.694,P < 0.001),uric acid(r = -0.420,P <0.001),and cystatin C levels(r = -0.553,P < 0.001),but a positive correlation with eGFR(r = 0.251,P = 0.034). Conclusion Plasma Hcy level may have a predictive value for renal dysfunction in patients with SCAD. Moreover,HHcy probably promoted renal dysfunction by inducing the imbalance of anti-inflammation and pro-inflammation in patients with SCAD.

Key words: hyperhomocysteinemia, inflammation, renal dysfunction, chronic stable artery disease

中图分类号: 

  • R541.4
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[4] 郑伟,杨智,安殿梅, ,孟冬娅,胡晓芳. 脑血管病患者高Hcy血症发生机制的初步研究[J]. 中国医科大学学报, 2012, 41(1): 69-72.
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