Objective To study the correlation between serum homocysteine ( HCY ) and coronary heart disease ( CHD ),and discuss the mechanism of HCY inducing CHD. Methods Among 109 CHD patients,71 with acute coronary syndrome ( ACS group ) and 38 with stable angina pectoris ( SAP group ),and at the same time 71 normal persons were selected as control group ( NC group ). The risk factors of cardiovascular diseases were investigated in all groups including sex,age,and history of hypertension,diabetes,hypercholesterolemia and smoking. The levels of serum HCY,high-sensitivity C-reactive protein ( hs-CRP ),total cholesterol ( TC ),and plasma fibrinogen ( FIB ) and D-dimer ( D-DT ) were detected. The multiple risk factors of CHD were analyzed by using unconditioned Logistic regression model. Results (T)The levels of serum HCY, hs-CRP and plasma FIB and D-DT were statistically different among ACS group,SAP group and NC group ( P <0. 05 ),and the levels of serum HCY and hs-CRP were statistically different between SAP group and NC group ( P < 0. 05 ), but the levels of FIB and D-DT had no statistical difference between SAP group and NC group ( P > 0. 05 ). The occurrence rate of hyperhomocysteinemia was significantly higher in ACS group and SAP group than that in NC group ( P <0. 01 ). ?The multiple analysis of Logistic regression showed that HCY was an independent risk factor of CHD, the related coefficient was 3. 665 and relative risk ( RR ) was 1. 118 ( P < 0.01 ). ?The level of serum HCY had difference between different sexes ( P < 0.05 ), but was not correlated to age ( P >0. 05 ). There was no statistical difference if the patients had history of hypertension, diabetes, hypercholesterolemia and smoking or not ( P > 0.05 ). The level of serum HCY is correlated to hs-CRP, FIB and D-DT ( P < 0. 05 ). Conclusion Hyperhomocysteinemia is an independent risk factor of CHD. HCY may increase the risk of CHD through inducing prethrombotic state by inflammatory reaction.%目的 研究血清同型半胱氨酸(HCY)与冠心病的相关性,并初步探讨其致冠心病的机制.方法 纳入109例冠心病患者,其中急性冠脉综合征患者(ACS组)71例,稳定型心绞痛患者(SAP组)38例,入选同期71例正常受试者作为对照组(NC组).调查入选对象存在的心血管疾病危险因素,包括:性别、年龄、高血压病史、糖尿病病史、高胆固醇血症史及吸烟史;检测受试者血清HCY、高敏-C反应蛋白(hs-CRP)、血清总胆固醇(TC)及血浆纤维蛋白原(FIB)、D-二聚体(D-DT);对冠心病的多重危险因素采用非条件logistic回归模型进行分析.结果 ①ACS组、SAP组与NC组患者血清HCY、hs-CRP、血浆FIB、D-DT水平差异有统计学意义(P＜0.05),且SAP组与NC组血清HCY及hs-CRP水平差异也具有统计学意义(P＜0.05),但SAP组与NC组血清FIB及D-DT水平无统计学差异(P＞0.05).ACS组及SAP组患者中高HCY血症发生率显著高于NC组(P＜0.01).②多元Logistic回归分析显示HCY为冠心病的独立危险因素,相关系数为3.665,相对危险度(OR)为1.118(P＜0.01).③冠心病患者中血清HCY水平在不同性别之间具有差异(P＜0.05),而与年龄无相关性(P＞0.05),在是否合并高血压、糖尿病、高胆固醇血症及吸烟史之间均无统计学差异(P＞0.05).血清HCY水平与hs-CRP、FIB、D-DT呈正相关(P＜0.05).结论 高HCY血症是冠心病的独立危险因素,HCY可能通过炎症反应及致机体处于血栓前状态,增加冠心病的发病风险.
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