血浆同型半胱氨酸与冠状动脉病变的关系探讨

摘要

Objective To investigate the correlation between plasma homocysteine in patients with coronary artery disease ( Hcy) associated with the severity of coronary artery lesion .Methods 178 patients with coronary angiography con-firmed coronary heart disease were enrolled as CHD group , and according to the number of diseased arteries , they were divid-ed into 1 vessel disease subgroup (48 cases), 2-vessel disease subgroup (57 cases), 3-vessel disease subgroup (73 cases). The same period 48 cases of normal patients were selected non-CHD group.Levels of plasma Hcy, total cholesterol (TC), three triacylglycerol (TG), high density lipoprotein (HDL) were detected and compared between the 2 groups, and to deter-mine the extent of coronary artery stenosis , record the Gensini coronary artery score .Results The levels of plasma Hcy , TC, TG of coronary heart disease group were higher than that in non CHD group , HDL was lower than that in non CHD group , the differences were statistically significant ( P <0.05).Coronary heart disease patients along with the severity of coronary artery disease , plasma Hcy level and Gensini score were increased , 1 vessel disease subgroup <2 vessel disease subgroup <3 ves-sel disease subgroup, and differences between former and non CHD group were statistically significant ( P <0.05).Logistic regression analysis revealed that Hcy , TC, TG were risk factors of coronary artery lesions ,while HDL was protective factor of coronary artery lesions;the differences were statistically significant ( P <0.05).Conclusion High Hcy is an independent risk factor of coronary heart disease , and increased with the severity of coronary artery lesions , according to detect Hcy level , the severity of coronary artery disease can be assessed .%目的：探讨冠心病患者血浆同型半胱氨酸（ Hcy）与冠状动脉病变程度的关系。方法选择行冠状动脉造影确诊为冠心病患者178例为冠心病组，并根据病变支数分为1支病变亚组（48例），2支病变亚组（57例），≥3支病变亚组（73例）。选择同期行冠状动脉造影检查正常者48例为非冠心病组。检测并比较2组患者血浆Hcy水平、总胆固醇（ TC）、三酰甘油（ TG）、高密度脂蛋白（ HDL），并测定冠心病组冠状动脉狭窄程度，记录Gensini冠状动脉病变积分。结果冠心病组血浆Hcy水平、TC、TG均高于非冠心病组，HDL低于非冠心病组，差异均有统计学意义（ P ＜0创．05）。冠心病患者随着冠状动脉病变程度的加重，血浆Hcy水平和Gensini评分均逐渐增加，1支病变亚组＜2支病变亚组＜≥3支病变亚组，与非冠心病组比较差异均有统计学意义（ P ＜0．05）。 Hcy、TC、TG是冠心病的危险因子，而HDL是冠心病的保护因子（ P ＜0．05）。结论高Hcy是冠心病独立危险因素，随着冠状动脉病变程度加重而升高，可通过检测Hcy水平评价冠状动脉病变程度。