血清同型半胱氨酸及脂蛋白（a）与冠心病的相关性研究

摘要

目的：探讨血清同型半胱氨酸及脂蛋白（a）与冠状动脉粥样硬化性心脏病（冠心病， CHD）的相关性。方法纳入经冠状动脉造影（CAG）确诊的冠心病患者84例，并将其分为稳定型心绞痛组（SAP组，28例）、急性冠脉综合症组（ACS组，56例）。另选同期56例拟诊为CHD而CAG正常的患者作为对照组（NC组）。检测各组血清同型半胱氨酸（Hcy）、脂蛋白a[Lp（a）]水平，同时根据冠状动脉（冠脉）造影结果对入选者行Gensini评分；对冠心病的多项危险因素进行多元logistic回归模型分析。结果 ACS组、SAP组与NC组患者血清Hcy、Lp（a）水平差异具有统计学意义（P＜0.05）。Pearson直线相关分析示，CHD患者Hcy、Lp（a）水平无相关性（r=0.240，P＞0.05），Gensini积分与血清Hcy、Lp（a）水平分别呈正相关（r=0.78、0.75，P均＜0.05)。多元Logistic回归分析显示Hcy（OR=1.287，95%CI：1.027~1.791）及Lp（a）（OR=3.038，95%CI：2.984~3.431）为冠心病的独立危险因素。结论高Hcy及高Lp（a）是冠心病的独立危险因素，与冠状动脉病变的严重程度相关。%Objective To discuss the correlation between serum homocysteine (Hcy) or lipoprotein (a) [LP (a)] and coronary heart disease (CHD).Methods CHD patients (n=84) diagnosed with coronary angiography (CAG) were divided into stable angina pectoris group (SAP group,n=28) and acute coronary syndrome group (ACS group, n=56), and other 56 patients with selective CHD and normal CAG were chosen as control group. The levels of serum Hcy and LP (a) were detected in all groups, and all patients were given Gensini scoring according to their CAG outcomes. The multiple risk factors of CHD were given multivariate Logistic regression analysis.Results The difference in levels of serum Hcy and LP (a) had statistical significance among 3 groups (P<0.05). Pearson linear correlation analysis showed that there was no correlation between Hcy level and LP (a) level (r=0.240,P>0.05), and Gensini integral was positively correlated to Hcy level and LP (a) level respectively (r=0.78,r=0.75; allP<0.05). The multivariate Logistic regression analysis showed that Hcy (OR=1.287, 95%CI: 1.027~1.791) and LP (a) (OR=3.038, 95%CI: 2.984~3.431) were independent risk factors of CHD.Conclusion Higher levels of Hcy and LP (a) are independent risk factors of CHD and correlated to the severity of CHD.