冠心病患者血清同型半胱氨酸水平与冠状动脉病变程度的关系

摘要

Objective: To discuss the relationship between serum homacysteine (Hey) level and coronary artery lesion severity. Method: 325 in hospital cases with coronary heart disease (CHD) diognosised by angiography were collected from October 2008 to October 2009. 325 cases were divided into CHD group(284 cases) and non CHD group(41 cases). Compare the diffrence of HCY.acidum folicum, Vit B12 amonge the two groups, and analysed the relationship between Serum homacysteineand level andthe degree of coronary artery disease. CHD group wes divided to single, double and multi-vessel subgroups according to the severity of vesular lesions. Serum homacysteine levels were also compared among the three subgroups respectively. Results: (l)The CHD group serum homacysteine level(24. 36 + 6. 62 pmol/Dwas significantly higher than non-CHD group (12. 26 ±4. Lfzmol/L). Serum homacysteine level were positively correlated with TCH(P<0. 01), negatively correlated with HDL(P<0. 01), FA(P<0. 01), VB)2(P<0. 05). (2) The level of serum hornacystein in three subgroups wes higher than non- CHD group, the integration of serum homacystein increased with the number of vesculae lesions increased gradually. The difference was significant (P<0. 01). (3)High level of serum Hcy.TC and TG, low level of serum HDL, FA and Vit B12were the risk factors of CHD using logstic regression analysis. Conclusion: The level of serum homacysteine can be used for indication of the degree of CHD in the clinical medicine.%高同型半胱氨酸(Hcy)和动脉粥样硬化之间可能存在病理联系,这一观点由MC Cully等于1969年首次提出,在近40年的研究中,人们通过流行病学调查,认为高Hcy是冠心病(CHD)、动脉粥样硬化的独立危险因素之一[1],Hcy与心肌梗死及其预后的关系也成为国内外学者研究的热点,但Hcy、叶酸(FA)、维生素B12( VB12)水平与冠状动脉病变程度的关系研究报道较少.为探讨Hcy与FA、V B12的相关关系以及对CHD病变的预警价值,本文对284例经冠状动脉造影确诊的CHD患者进行血清Hcy、FA、VB12浓度及血脂水平检测,并分析Hcy与其它指标的相关性,分析不同程度冠脉病变CHD患者Hcy水平的变化以及CHD危险因素,为临床通过调整Hcy水平、防治CHD提供依据.