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目的 研究慢性肾功能衰竭（ＣＲＦ）患者血浆同型半胱氨酸（Ｈｃｙ）水平、影响因素以及与心、脑血管疾病的关系。方法 采用荧光偏振免疫分析法测定１６０例ＣＲＦ患者血浆总同型半胱氨酸（ｔＨｃｙ）水平，以３１例冠心病患者和４５例正常人为对照。结果 以正常组血浆ｔＨｃｙｘ±２ｓ为９５％可信度上限，ＣＲＦ患者高同型半胱氨酸血症的发生率为８２．５０％，明显高于冠心病组（２２．５８％）（Ｐ＜０．０１）；血液透析（ＨＤ）组血浆ｔＨｅｙ水平［（２４．１３±１２．６８）μｍｏｌ／Ｌ，ｎ＝７３］明显高于持续性非卧床腹膜透析（ＣＡＰＤ）组［（１６．４３ ±５．５８）μｍｏｌ／Ｌ，ｎ＝１９］、冠心病组［（１１．１３±４．９７）μｍｏｌ／Ｌ，ｎ＝３１］以及正常组（７．９７±２．６５）μｍｏｌ／Ｌ，ｎ＝４５，Ｐ均＜０．０１。９２例透析治疗的ＣＲＦ患者中有明确心、脑血管病者的血浆ｔＨｃｙ水平［（２７．１２±１５．９４）μｍｏｌ／Ｌ，ｎ＝３０］明显高于无此类病史的患者［（２０．１７±８．７１）μｍｏｌ／Ｌ，ｎ＝６２］。未经透析的 ＣＲＦ患者血浆 ｔＨｃｙ水平与内生肌酐清除率呈负相关（ｒ＝－０．３７４，Ｐ＜０．０１），与患者年龄、血葡萄糖、血脂及血浆白?
Objective To investigate the plasma homocysteine (Hcy) levels, the influencing factors and the relationship with cardiovascular and cerebrovascular diseases in patients with chronic renal failure (CRF). Methods Plasma total homocysteine (tHcy) levels were measured in 160 patients with CRF by fluorescence polarization immunoassay. The control group consisted of 31 CHD patients and 45 healthy controls. Results The plasma tHcyx ± 2s in the normal group was the upper limit of 95% confidence. The incidence of hyperhomocysteinemia in CRF patients was 82.50%, significantly higher than that in coronary heart disease patients (22.58%, P < 0.01). The plasma levels of tHey in hemodialysis group [(24.13 ± 12.68) μmol / L, n = 73] were significantly higher than those in CAPD group [(16.43 ± 5.58) μmol / L, n = 19], coronary heart disease group (11.13 ± 4.97) μmol / L, n = 31 and normal group (7.97 ± 2.65) μmol / L , N = 45, all P <0.01. The level of plasma tHcy in patients with CRF was significantly higher than that in patients with dialysis ([27.12 ± 15.94] μmol / L, n = 30] Significantly higher than those without such history [(20.17 ± 8.71) μmol / L, n = 62]. The level of tHcy in plasma was negatively correlated with the clearance rate of endogenous creatinine (r = -0.374, P <0.01) in CRF patients without dialysis, but not with age, blood glucose, blood lipid and plasma white