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临床输血与检验

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (3): 312-315.DOI: 10.3969/j.issn.1671-2587.2020.03.022

• 临床检验 • 上一篇    下一篇

维持性血液透析患者同型半胱氨酸变化及其相关因素分析

刘雯雯, 袁丁   

  1. 230022 合肥,安徽医科大学附属合肥第三临床学院,合肥市第三人民医院肾内科
  • 收稿日期:2018-09-07 出版日期:2020-06-20 发布日期:2020-06-13
  • 作者简介:刘雯雯（1983-）,女,安徽铜陵人,主治医生,学士,主要从事血液透析方面研究,（Tel）13965025963（E-mail）yiaokeji@126.com。

The Levels of Serum Homocysteine in Patients with Maintenance Hemodialysis and Its Relevant Factors Analysis

LIU Wen-wen, YUAN Ding   

  1. Department of Nephrology; Hefei Third Clinical College, Anhui Medical University The Third People's Hospital of Hefei city,Hefei 230022
  • Received:2018-09-07 Online:2020-06-20 Published:2020-06-13

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摘要： 目的 探讨维持性血液透析（MHD）患者同型半胱氨酸（Hcy）水平变化及其相关因素分析。方法 选取本院维持性血液透析（透析龄>3个月）患者82例,检测血清Hcy水平,根据Hcy水平分成低Hcy组（Hcy<15μmol/L）与高Hcy组（Hcy≥15 μmol/L）;对比两组患者生化指标的异同,采用Pearson相关分析、Logistic回归模型分析影响Hcy的因素。结果 ①MHD患者血清Hcy平均水平为（42.15±7.28）μmol/L,其中高Hcy发生率为72.0%（59/82）;②与低Hcy组比较,高Hcy组白蛋白、血红蛋白、高密度脂蛋白、血钙水平均明显降低,而低密度脂蛋白、血糖、血尿酸、收缩压、舒张压水平均明显升高;③Pearson分析显示：Hcy与低密度脂蛋白、血糖、血尿酸、收缩压、舒张压水平均呈明显正相关（r分别为0.511、0.614、0.732、0.704、0.682, P均<0.05）,与白蛋白、血红蛋白、高密度脂蛋白呈明显负相关（ r分别为-0.663、-0.728、-0.584,P均<0.05）;Logistic回归模型显示：低密度脂蛋白、血糖、尿酸、收缩压和舒张压为Hcy的独立危险因素,血白蛋白和血红蛋白为Hcy的保护因素。结论 MHD患者高Hcy发生率高;低密度脂蛋白、血糖、尿酸、收缩压和舒张压为Hcy的独立危险因素,白蛋白与血红蛋白为Hcy的保护因素。

关键词: 维持性血液透析, 同型半胱氨酸, 慢性肾脏病, 相关性

Abstract: Objective To observe the levels of serum homocysteine（Hcy） in the patients with maintenance hemodialysis （MHD）,and analysis of the affected factors related to homocystein. Methods There were 82 patients with maintenance hemodialysis （The dialysis duration is more than 3 months） were selected for this study. They were divided into high homocysteine group （59 cases,Hcy≥15μmol/L） and low homocysteine group （23 cases,Hcy<15μmol/L） according to the levels of serum homocysteine. The differences of biochemical index between the low homocysteine group and the high homocysteine group were compared, and the affected factors related to homocystein were analysed by Pearson correlation analysis/Logistic regression analysis. Result ①The average of the serum homocysteine is （42.15±7.28） μmol/L and the proportion of high homocysteine is 72%. ② Compared with the low homocysteine group,the levels of albumin, hemoglobin, high density lipoprotein and calcium in the high homocysteine were significantly decreased, but the levels of Low density lipoprotein, Fasting plasma glucose, Blood uric acid, Systolic blood pressure and Diastolic blood pressure were significantly increased. ③ Pearson linear correlation analysis show that the levels of homocysteine are positively correlation with the Low density lipoprotein, Fasting plasma glucose Blood uric acid, Systolic blood pressure and Diastolic blood pressure,while are negatively correlation with the albumin, high density lipoprotein and hemoglobin. Logistic regression analysis showed that albumin and hemoglobin were protective factors for homocysteine and the Low density lipoprotein, Fasting plasma glucose, Blood uric acid, Systolic blood pressure and Diastolic blood pressure were hazards factors for homocysteine. Conclusions The incidence of high homocysteine in patients with MHD was high;the albumin and hemoglobin were protective factors and the Low density lipoprotein, Fasting plasma glucose, Blood uric acid, Systolic blood pressure and Diastolic blood pressure were hazards factors for homocysteine.

Key words: Maintenance Hemodialysis, Homocysteine, Chronic kidney disease, Correlation

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