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24h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-proB-NP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-proB-NP、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.

abstractsObjective To investigate the correlation between serum homocysteine (HCY) and chronic heart failure (CHF) hypercoagulable state in patients.Methods A 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.Results Compared 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).Conclusions HCY 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.