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目的:探讨1～4期慢性肾脏病患者同型半胱氨酸与心血管病相关性。方法:回顾性分析新疆医科大学第一附属医院186例慢性肾脏病1～4期临床资料,分析同型半胱氨酸与颈动脉内中膜增厚、颈动脉粥样斑块的相关性。结果:单因素相关分析显示,颈动脉IMT与年龄、收缩压、纤维蛋白原、血尿酸及同型半胱氨酸呈正相关,而与肾小球滤过率呈负相关。颈动脉斑块与年龄、血尿酸及同型半胱氨酸呈正相关,而与肾小球滤过率呈负相关。偏相关分析示颈动脉内—中膜厚度、颈动脉斑块与同型半胱氨酸呈正相关,r分别为0.642、0.592,P=0.000。多因素逐步回归未发现同型半胱氨酸是颈动脉内—中膜厚度的独立危险因素,而是颈动脉斑块的独立危险因素。结论:慢性肾脏病患者动脉粥样硬化病变与循环中高水平的同型半胱氨酸有关:高同型半胱氨酸血症可能是慢性肾脏病患者心血管病发生的危险因素。其作用机制仍有待进一步研究证实。
Objective: To investigate the correlation between homocysteine and cardiovascular disease in patients with stage 1 ~ 4 chronic kidney disease. Methods: The clinical data of 186 patients with chronic kidney disease in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The correlation between homocysteine and carotid artery intima-media thickness and carotid atherosclerotic plaque was analyzed. Results: Univariate correlation analysis showed that carotid IMT was positively correlated with age, systolic blood pressure, fibrinogen, serum uric acid and homocysteine, but negatively correlated with glomerular filtration rate. Carotid plaque was positively correlated with age, serum uric acid and homocysteine, but negatively correlated with glomerular filtration rate. Partial correlation analysis showed that carotid intima-media thickness and carotid plaque were positively correlated with homocysteine (r = 0.642, 0.592, P = 0.000). Multi-factor regression showed no homocysteine was an independent risk factor for intima-media thickness of the carotid artery, but an independent risk factor for carotid plaque. CONCLUSION: Atherosclerotic lesions in patients with chronic kidney disease are associated with high levels of circulating homocysteine: hyperhomocysteinemia may be a risk factor for cardiovascular disease in patients with chronic kidney disease. Its mechanism remains to be confirmed by further research.