【摘要】 目的探讨老年射血分数保留心力衰竭(HFpEF)患者血清同型半胱氨酸(Hcy)与心功能的相关性分析。方法选取2014年3月-2019年2月在我院接受治疗的63例老年HFPEF患者为观察组。选取同期体检的健康志愿者35例作为对照组。比较2组受试者的性别、年龄、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、Hcy、N末端B型脑钠肽前体(NT-proBNP)、高敏C-反应蛋白(hs-CRP)、左心室舒张末期内径(LVEDD)及左心室射血分数(LVEF)。根据纽约心脏病学会(NYHA)心功能分级标准将观察组进行分组:心功能Ⅱ级组23例、Ⅲ级组20例、Ⅳ级组20例,检测和比较3组的Hcy、NT-proBNP、hs-CRP、LVEF及LEVDD。分析Hcy与NT-proBNP、hs-CRP、LVEF、LVEDD等的相关性。结果 2组受试者的性别、年龄、BMI、SBP、DBP、吸烟史、饮酒史、合并高血压病和合并糖尿病等临床资料比较,差异无统计学意义(P>0.05)。与对照组比较,观察组的Hcy、NT-proBNP、hs-CRP和LEVDD水平均显著升高(P<0.05),LVEF明显降低(P<0.05)。观察组随着心功能分级级别增加,Hcy、NT-proBNP、hs-CRP、LEVDD水平逐渐升高,LVEF逐渐减少(P<0.05)。Pearson相关性分析显示:Hcy与NT-proBNP、hs-CRP及LVEDD显著相关,均呈正相关(分别为0.717、626和0.732,P均<0.05);与LVEF呈负相关(=-0.438,P<0.05)。结论老年HFpEF患者血清Hcy水平明显升高,随着心功能分级级别增加呈逐渐升高趋势,且与NT-proBNP、hs-CRP、LVEF和LVEDD呈明显相关性。更多还原

【Abstract】 Objective To investigate the correlation between serum homocysteine(Hcy) and cardiac function in the elderly with heart failure with preserved ejection fraction(HFp EF). Methods 63 elderly with HFp EF during the period from March 2014 to February 2019 were recruited in observation group and 35 norms of physical examination in control group; a comparative study was made between the 2 groups in sex, age, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), Hcy level, N-terminal brain natriuretic propeptide(NT-proBNP) level, high-sensitivity C-reactive protein(hs-CRP)level, left ventricular end-diastolic diameter(LVEDD) and left ventricular ejection fraction(LVEF); according to New York Heart Association(NYHA) standard, observation group was further divided into 3 sub-groups: cardiac function II group( =23),cardiac function III group( =20) and cardiac function IV group( =20); the levles of Hcy, NT-pro BNP, hs-CRP, LVEF and LEVDD of the elderly in the 3 subgroups were detected and a comparison was conducted among the 3 subgroups; the correlation between the level of Hcy and the levels of NT-proBNP, hs-CRP, LVEF and LVEDD was analyzed. Results There existed no statistical differences in the clinical data between observation group and control group, such as sex, age, BMI, SBP, DBP,smoking history, drinking history, and complicated hypertension and diabetes mellitus(P>0.05); the levels of Hcy, NT-proBNP,hs-CRP and LEVDD of the elderly in observation group were higher and the level of LVEF was lower than those of the elderly in control group(P<0.05); the level of Hcy, NT-pro BNP, hs-CRP and LEVDD kept rising and the level of LVEF kept dropping with the increase of cardiac function grading(P<0.05); Pearson correlation analysis indicated the level of Hcy was in close positive correlation with the levels of NT-proBNP, hs-CRP and LVEDD( =0.717, =626, =0.732, P<0.05) and in negative correlation with the level of LVEF( =-0.438, P<0.05). Conclusions The level of Hcy in the cases with HFp EF is obviously higher and keeps going up with the increase of cardiac function grading, it is in a correlation with the levels of NT-pro BNP, hs-CRP, LVEF and LVEDD.更多还原