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      标题:同型半胱氨酸在扩张型心肌病心力衰竭左室重构和心肌损伤中的临床意义
      作者:高 伟 1,王志永 2,王雪艳 3
    (1.安新县医院心内科,河北 安新 071600;
2.天津医科大学心血管病临床学院内二科,天津 300457;
3.永清县人民医院内科,河北 永清 065699)
      卷次: 2013年24卷4期
      【摘要】 目的 探讨同型半胱氨酸(HCY)在扩张型心肌病心力衰竭左室重构和心肌损伤中的临床意义。
方法 选取2008年3月至2012年6月扩张型心肌病(DCM)心衰患者89例,按照HCY水平分为HCY正常组43
例和HCY升高组46例,观察血清HCY水平与左室射血分数、左室舒张末期容积、左室短轴缩短率和左室后壁厚
度以及心肌酶学、血清肌钙蛋白的关系。结果 与HCY正常组比较HCY升高组的LVEDV显著升高(P<0.01),
LVEF、LVFS 和LVPW显著降低(P<0.05),HCY升高组的CK-MB、AST和LDH水平显著升高(P<0.05),cTnT和
cTnI水平显著升高(P<0.01),以上两组间的差异均有统计学意义。结论 血清HCY可作为DCM心力衰竭左室
重构和心肌损伤严重程度的有效评价指标。

      【关键词】 扩张型心肌病;同型半胱氨酸;超声心动图描记;心肌酶学;肌钙蛋白

      【中图分类号】 R542.2 【文献标识码】 A 【文章编号】 1003—6350(2013)04—0478—03

Clinical significance of homocysteine in dilated cardiomyopathy heart failure with left ventricular remodeling
and myocardial damage. GAO Wei 1, WANG Zhi-yong 2, WANG Xue-yan 3 . 1. Department of Cardiology, Anxin County
Hospital, Anxin 071600, Hebei, CHINA; 2. The Second Department of Internal Medicine, Cardiovascular Clinical Institute
of Tianjin Medical University, Tianjin 300457, CHINA; 3. Department of Internal Medicine, Yongqing County Hospital,
Yongqing 065699, Hebei, CHINA

      【Abstract】 Objective To study the clinical significance of homocysteine (HCY) in dilated cardiomyopathy
heart failure with left ventricular remodeling and myocardial damage. Methods Eighty-nine patients with dilated car-
diomyopathy (DCM) heart failure from March 2008 to June 2012 were divided into normal HCY group (n=43) and in-
creased HCY group (n=46) according to serum HCY levels. The relationship between serum homocysteine levels and
left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular fraction-
al shortening rate (LVFS) and left ventricular posterior wall thickness (LVPW), serum cardiac enzymes, and se-
rum troponin were observed. Results LVEDV was significantly higher in normal HCY group than increased
HCY group (P<0.01). LVEF, LVFS and LVPW were significantly lower in normal HCY group than increased HCY
group (P<0.05). CK-MB, AST and LDH were significantly higher in normal HCY group than increased HCY group
(P<0.05), as well as cTnT and cTnI (P<0. 01). Conclusion Serum HCY can be used as the effective evaluation of se-
verity in patients of DCM heart failure with left ventricular remodeling and myocardial damage.

      【Key words】 Dilated cardiomyopathy; Homocysteine; Echocardiography tracings; Cardiac enzymes; Troponin

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