关键词: 心力衰竭, 半胱氨酸, 利钠肽,脑, 心功能

Abstract:

ObjectiveTo investigate the role of plasma homocysteine and its clinical significance in chronic heart failure  patients by observing the relationship of plasma homocysteine (Hcy) and B type natriuretic peptide (BNP).MethodsA total of 151 chronic heart failure patients including 93 males and 58 females， average age （66.7±11.6） years were investigated，and  249 patients with normal cardiac function at the same time of hospitalization served as control group.Plasma  Hcy， BNP，lipids， blood glucose were studied.Results①The plasma Hcy concentration in heart failure  patients was significantly higher than control group (19.90±5.07)  μmol/L vs  (14.84±4.87) μmol/L(P<0.01);The serum BNP concentration in heart failure patients was significantly higher than control group (1 851.67±742.59) ng/L vs  (197.5±84.5)  ng/L(P<0.01). ② The plasma Hcy and BNP were different from New York Heart Association (NYHA) classes  (P<0.01). ③ The plasma Hcy and BNP were linear positive correlation (r=0.629，P<0.01). ④The results of logistic regression showed that hypertension (OR=1.826，95%CI=1.0213.266，P<0.05），diabetes (OR=1.716，95%CI=1.0202.887，P<0.05)，hyperlipidemia (OR=1.856，95%CI=1.0153.396，P<0.05)，smoking (OR=1.952，95%CI=1.2333.089，P<0.05)，Hcy(OR=3.743，95%CI=2.2716.169，P<0.01)  were risk factors for patients with chronic heart failure.⑤Receiver operating characteristic curve analysis indicated the cut  off of Hcy for chronic  heart failure was 17.75  μmo/L (ROC area under curve: 0.754，95%CI=0.7060.802，P<0.01) with 73.90% specificity and 66.20%  sensitivity.ConclusionHcy  is an independent risk factor for chronic heart failure， and the cut of value can be used as a new diagnostic index for chronic heart failure.

Key words: heart failure, cysteine, natriuretic , peptide, brain, cardiac function