中文摘要：

目的研究高同型半胱氨酸血症（HHcy）对慢性稳定性冠状动脉粥样硬化性心脏病（SCAD）患者肾功能的影响及其可能机制。方法将100例SCAD患者按其血浆同型半胱氨酸（Hcy）水平分为HHcy组（Hcy≥15μmol／L，n=53）和对照组（Hcy〈15μmol／L，n=47）。观察肾功能指标与Hcy以及血清白细胞介素6（IL-6）和脂联素（APN）水平的关系。结果HHcv组患者血清IL-6水平较对照组显著升高（P〈0．05），血清APN水平较对照组显著下降（P〈0．05）。相关性分析显示，血浆Hcv水平与肌酐（r=0．379，P〈0．001）、尿酸（r=0．238，P=0．019）、胱抑素C（r=0．513，P〈0．001）及IL-6（r=0．561，P〈0．001）呈正相关，而与肾小球滤过率（r=-0．288，P=0．023）及APN水平（r=-0．428，P〈0．001）呈负相关。进一步分析示，IL-6与肌酐（r=0．406，P=0．002）、尿酸（r=0．359，P=0．007）、胱抑素C（r=0．387，P=0．007）呈正相关，与肾小球滤过率（r=-0．370，P=0．005）呈负相关：APN与肌酐（r=-0．694，P〈0．001）、尿酸（r=-0．420，P〈0．001）、胱抑素C（r=-0．553，P〈0．001）呈负相关，而与肾小球滤过率（r=0．251，P=0．034）呈正相关。结论血浆Hcy水平可能对SCAD人群肾功能减退具有预测价值。在SCAD人群中，血浆H。v可能通过引发机体促炎和抗炎机制失衡来加重SCAD患者肾功能不全。

英文摘要：

Objective To investigate the possible mechanism of hyperhomoeysteinemia （HHcy） in renal dysfunction in patients with chronic stable coronary artery disease （SCAD）. Methods We consequentially enrolled patients diagnosed as having SCAD and, according to homocysteine （Hcy） levels, divided them into the HHcy group （Hcy≥15μmol/L,n=53） and control group （Hcy〈15μmol/L,n=47）. We further tested the relationship among plasma Hcy level, renal function, and serum levels of interleukin （IL） -6 and adiponectin （APN）. Results IL-6 was significantly higher in the HHcy group than in the control group （P 〈 0.05 ）. However, APN level was obviously lower in the HHcy group than in the control group （P 〈 0.05 ）. Correlation analysis revealed that Hcy level positively correlated with creatinine （r = 0.379, P 〈 0.001 ） , uric acid （r = 0.238, P = 0.019）, cystatin C （r = 0.513, P 〈 0.001 ）, and IL-6 levels （r = 0.561, P 〈 0.001 ） but negatively correlated with estimated glomerular filtration rate （ eGFR; r = -0.288, P = 0.023 ） and APN level （r = -0.428, P 〈 0.001 ）. IL-6 level showed positive correlations with creatinine （ r = 0.406, P = 0.002）, uric acid （r = 0.359, P = 0.007）, and cystatin C levels （r = 0.387, P = 0.007） but a negative correlation with eGFR （r = -0.370, P = 0.005 ）. Meanwhile, APN level showed negative correlations with creatinine （r = -0.694, P 〈 0.001 ）, uric acid （r = -0.420, P 〈 0.001 ）, and cystatin C levels （r = -0.553, P 〈 0.001 ）, but a positive correlation with eGFR （r = 0.251, P = 0.034）. Conclusion Plasma Hcy level may have a predictive value for renal dysfunction in patients with SCAD. Moreover, HHcy probably promoted renal dysfunction by inducing the imbalance of anti-inflanmmation and pro-inflammation in patients with SCAD.