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目的探讨同型半胱氨酸(Hcy)及冠心病传统危险因素对缺血性心肌病的影响。方法分析2006年10月至2007年3月48例住院缺血性心肌病患者吸烟史、糖尿病、高血压、年龄、性别、血脂及血清Hcy水平,比较2组Hcy水平的差异,并采用logistic逐步回顾分析的方法讨论与缺血性心肌病相关的独立危险因素。设31例同期内科系统住院的心、肝、肾、脑、肺功能正常的非心脏病患者为对照组,并测定其血清Hcy水平。结果(1)不同年龄、性别,有无高血压史、糖尿病史、吸烟史,不同血脂指标水平者之间,其血浆Hcy水平无统计学差异。缺血性心肌病组Hcy水平显著高于对照组〔(20.90±11.75)μmol/Lvs(14.80±7.31)μmol/L,P<0.05〕;缺血性心肌病高Hcy血症发生率明显高于对照组(79.2%vs16.1%,P<0.01)。(2)多因素Logistic回归分析显示Hcy水平、吸烟、高血压、高胆固醇血症是缺血性心肌病的危险因素。结论Hcy是缺血性心肌病的独立危险因素。Hcy与冠心病的传统危险因素相比对缺血性心肌病的影响较大,与之呈较强相关性。
Objective To investigate the effect of homocysteine (Hcy) and traditional risk factors of coronary heart disease on ischemic cardiomyopathy. Methods The smoking history, diabetes mellitus, hypertension, age, sex, blood lipid and serum Hcy level in 48 hospitalized patients with ischemic cardiomyopathy from October 2006 to March 2007 were analyzed. The differences of Hcy level between the two groups were compared. Retrospective analysis discusses the independent risk factors associated with ischemic cardiomyopathy. 31 cases of non-heart disease patients with normal heart, liver, kidney, brain and lung function were enrolled in the same period as the control group, and serum Hcy levels were measured. Results (1) There was no significant difference in plasma Hcy levels among different age, gender, history of hypertension, history of diabetes, smoking history and different levels of serum lipids. The level of Hcy in ischemic cardiomyopathy group was significantly higher than that in the control group [(20.90 ± 11.75) μmol / L vs (14.80 ± 7.31) μmol / L, P <0.05) Control group (79.2% vs 16.1%, P <0.01). (2) Multivariate Logistic regression analysis showed that Hcy levels, smoking, hypertension and hypercholesterolemia were risk factors for ischemic cardiomyopathy. Conclusion Hcy is an independent risk factor for ischemic cardiomyopathy. Hcy and the traditional risk factors of coronary heart disease on ischemic cardiomyopathy greater impact, with a strong correlation.