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目的探讨慢性肾脏病患者同型半胱氨酸水平与动脉粥样硬化的相关性。方法回顾性分析186例慢性肾脏病患者的临床资料,采用荧光偏振免疫分析法检测血清同型半胱氨酸水平,测定颈动脉内膜中层厚度,按照简化的MDRD方程,估算出肾小球滤过率(eGFR),根据eGFR将CKD患者分为3组:A组eGFR≥60mL/(min.1.73m2);B组eGFR 15～59mL/(min.1.73m2);C组eGFR<15mL/(min.1.73m2)。以同期健康体检病人作为对照组。分析同型半胱氨酸与颈动脉内膜中层厚度(IMT)、颈动脉粥样斑块的相关性。结果慢性肾脏病患者同型半胱氨酸、颈动脉内膜中层厚度均较对照组明显升高(P<0.05),颈动脉内膜中层厚度(IMT)高的病人血浆同型半胱氨酸水平升高(P<0.05)。结论慢性肾脏病患者血浆同型半胱氨酸水平与动脉粥样硬化病变有密切关系,可能是慢性肾脏病动脉粥样硬化的危险因素。
Objective To investigate the correlation between homocysteine level and atherosclerosis in patients with chronic kidney disease. Methods The clinical data of 186 patients with chronic kidney disease were retrospectively analyzed. Serum homocysteine level was measured by fluorescence polarization immunoassay, and the intima-media thickness of carotid artery was measured. Based on the simplified MDRD equation, glomerular filtration rate (EGFR). According to eGFR, CKD patients were divided into three groups: eGFR≥60mL / (min.1.73m2) in group A; eGFR: 15-59mL / (1.73m2) in group B; eGFR <15mL / .1.73 m2). In the same period as a healthy medical examination patients as a control group. The correlation between homocysteine and carotid artery intima-media thickness (IMT) and carotid atherosclerotic plaques was analyzed. Results Homocysteine and carotid artery intima-media thickness were significantly increased in patients with chronic kidney disease (P <0.05). Plasma homocysteine levels in patients with high carotid intima-media thickness (IMT) High (P <0.05). Conclusion Plasma homocysteine level in patients with chronic kidney disease is closely related to atherosclerotic lesions and may be a risk factor for atherosclerosis in chronic kidney disease.