李忆 张艳宁

[摘要] 同型半胱氨酸（Homocysteine，Hcy）是衍生于蛋氨酸代谢的一种含硫的非必需氨基酸，主要通过食物和内源蛋白质分解获取，在体内含量很少，许多因素会导致体内Hcy的水平升高，如服用药物、蛋氨酸代谢酶的改变、维生素B12、B6、叶酸等缺乏，以及相关的肾脏损害。慢性肾脏病（Chronic kidney disease，CKD）在全世界范围内的发病率呈上升的趋势，已成为一个威胁人类健康的重要疾病。一项对44个国家的患病率研究进行的荟萃分析估计，全球CKD患病率为13.4%。研究表明，受CKD影响的人群发生心血管疾病（Cardiovascular diseases，CVD）的危险性较一般人群显著增高，CKD被认为是CVD的独立危险因素，而CVD是导致CKD死亡的主要原因。由于各种传统危险因素无法完全解释这种增加的心血管风险，近年来，越来越多的研究表明非传统因素，如高同型半胱氨酸血症对CKD患者发生心血管疾病起到了一定的作用。下面就其相关作用机制进行一系列阐述。

[关键词] 同型半胱氨酸;慢性肾脏病;心血管疾病;维生素;叶酸

[中图分类号] R692          [文献标识码] A          [文章编号] 1673-9701（2020）22-0186-07

Research progress of homocysteine in the occurrence and development of chronic kidney disease and cardiovascular disease

LI Yi   ZHANG Yanning

Northern Theater General Hospital， Shenyang   110000，China

[Abstract] Homocysteine（Hcy） is a sulfur-containing non-essential amino acid derived from methionine metabolism. It is mainly obtained through the decomposition of food and endogenous proteins， with a trace amount found in the body. Many factors can lead to increased levels of Hcy in the body， such as taking drugs， changes in methionine metabolic enzymes， deficiency of vitamin B12， B6， folic acid and other vitamins， and related kidney damage. The incidence rate of chronic kidney disease（CKD） in the world is on the rise， and it has become an important disease threatening human health. A meta-analysis from a study on the prevalence of CKD in 44 countries has estimated that the global prevalence of CKD is 13.4%. Studies have shown that people affected by CKD have a significantly higher risk of developing cardiovascular diseases（CVD） than the general population. CKD is considered as an independent risk factor for CVD，and CVD is the main cause of CKD-related death. Because various traditional risk factors cannot fully explain this increased cardiovascular risk， in recent years， more and more studies have shown that non-traditional factors， such as hyperhomocysteinemia， play a certain role in the development of cardiovascular disease in CKD patients. Its related mechanism of action is elaborated as followed.

[Key words] Homocysteine（Hcy）; Chronic kidney disease; Cardiovascular disease; Vitamin; Folic acid

同型半胱氨酸（Homocysteine，Hcy）是衍生于蛋氨酸代謝的一种含硫的非必需氨基酸，主要通过食物和内源蛋白质分解获取，在体内含量很少，许多因素会导致体内Hcy的水平升高，如服用药物、蛋氨酸代谢酶的改变、维生素B12、B6、叶酸等缺乏，以及相关的肾脏损害。慢性肾脏病（Chronic kidney disease，CKD）在全世界范围内的发病率呈上升的趋势，已成为一个威胁人类健康的重要疾病。一项对44个国家的患病率研究进行的荟萃分析估计，全球CKD患病率为13.4%[1]。……