心绞痛患者血清Hcy含量及其与冠脉病变程度、血清炎性因子水平的关系

摘要

目的：探讨心绞痛患者血清同型半胱氨酸(Hcy)的含量及其与冠脉病变程度、血清炎性因子水平的关系。方法选择在本院接受住院治疗的心绞痛患者128例作为观察组，按照冠脉病变程度分为1支病变组34例，2支病变组62例，3支病变组32例，同时选择同期在本院体检的健康人58例作为对照组，检测血浆Hcy、叶酸、维生素B12以及炎性因子水平。结果(1)观察组患者的血浆Hcy水平高于对照组，叶酸、维生素B12水平低于对照组，差异有统计学意义(P<0.05)；(2)心绞痛不同病变程度患者的血浆Hcy、叶酸、维生素B12水平差异有统计学意义(P<0.05）；且病变程度越重，血浆Hcy水平越高，叶酸、维生素B12水平越低，差异有统计学意义(P<0.05)；(3)心绞痛患者的血浆炎性因子水平均高于对照组，且病变程度越重，血浆炎性因子含量越高差异有统计学意义(P<0.05)；(4)血浆Hcy水平与C反应蛋白(CRP)、白介素-6(IL-6)、白介素-10(IL-10)水平呈正相关；叶酸、维生素B12水平与CRP、IL-6、IL-10水平呈负相关。结论心绞痛患者血浆Hcy、叶酸、维生素B12以及IL-10、IL-6、CRP水平上升，且Hcy相关指标与冠脉病变程度、血清炎性因子水平具有相关性。%Objective To analyze homocysteine (Hcy) level in patients with angina and its relationship with coronary artery lesions degree, serum inflammatory cytokines levels. Methods A total of 128 patients with angina in our hospital were choose as observation group, which were divided into three groups according to degree of coronary lesion: one lesion group (34 cases), two lesions group (62 cases), three lesions group (32 casess). At same time, 58 healthy check-up people in our hospital were selected as control group. The levels of Hcy, folate, vitamin B12 and in-flammatory cytokines were detected. Results (1) The level of Hcy in the observation group was significantly higher than that of the control group, while folate, vitamin B12 levels were significantly lower (P<0.05). (2) The levels of Hcy, folate, vitamin B12 showed statistically significant difference between the three groups of patients with different degree of coronary lesion. As lesion degree got worse, Hcy level was higher, and folate, vitamin B12 levels were lower (P<0.05). (3) The inflammatory factor levels in patients with angina were significantly higher than those of control group. As lesion degree got worse, the inflammatory factors levels became significantly higher (P<0.05). (4) Hcy level was positively correlated with the levels of interleukin-10 (IL-10), interleukin-6 (IL-6), C-reactive protein (CRP). Folate, vitamin B12 levels were negatively correlated with the levels of IL-10, IL-6, CRP. Conclusion The plasma levels of Hcy, folate, vitamin B12, as well as IL-10, IL-6, CRP, all increase in patients with angina. Hcy related indexes are cor-related with coronary artery lesion degree and serum inflammatory factors levels.