急性冠状动脉综合征患者血清同型半胱氨酸水平与冠状动脉病变关系的研究

目的 探讨急性冠状动脉综合征(ACS)患者血清同型半胱氨酸(HCY)水平的变化及与冠状动脉病变的关系.方法 经冠状动脉造影证实的ACS患者178例为ACS组,65例冠状动脉造影正常者为对照组.所有患者均用循环酶法测定血清HCY水平.ACS患者按冠状动脉病变支数分为单支病变组59例、双支病变组65例、三支病变组54例；根据冠状动脉病变Gensini分值不同分为Gensini评分＜20组、Gensini 评分20 ～40组、Gensini评分＞40组.对于ACS患者血清HCY水平与冠状动脉病变支数及狭窄程度的关系进行分析.结果 ACS组患者血清HCY水平明显高于对照组(20±6)μmol/L比(8±4) μmol/L] (P＜0.01)；血清HCY水平在冠状动脉病变三支病变组(23±5)μmol/L]明显高于双支病变组(21±4)μmol/L]及单支病变组(18 ±4)μmol/L],差异有统计学意义(均P＜0.01).血清HCY水平在冠状动脉病变Gensini评分＞40组(25±6) μmol/L]明显高于Gensini评分20～ 40组(21 ±4)μmol/L]及Gensini评分＜20组(16±3)μmol/L],差异有统计学意义(均P＜0.01).结论 ACS患者血清HCY水平明显升高,血清HCY的水平与冠状动脉病变支数及严重程度相关.

Clinical study of serum homocysteine in acute coronary syndrome patients and the relationship between the severity of coronary lesions and the levels of serum homocysteine

Objective To explore the levels of serum homocysteine （HCY） and the relationship between the HCY and the severity of coronary lesions in acute coronary syndrome （ACS）. Methods Totally 178 patients who were diagnosed of ACS by coronary artery angiography and 65 cases as a normal control group were enrolled. The levels of HCY were detected. The patients with ACS were divided into one-artery lesion group, two-artery lesion group and three-artery lesion group according to the number of coronary artery lesions. The patients with ACS were also divided into Gensini score 〈 20 group, Gensini score 20-40 group and Gensini score 〉 40 group by Gensini score of coronary artery lesion. The correlation between the number of coronary artery lesions and serum HCY, the severity of coronary lesions and serum HCY was analyzed. Results Serum level of HCY was significantly higher in patients with ACS than that in normal group （20±6） μ mol/L vs （8±4） μmol/L] （P 〈 0.01 ）. Serum level of HCY in three-artery lesion group （23± 5）μmol/L] was significantly higher than that in two-artery lesion group （21 ±4）μmol/L]and one-artery lesion group （ 18±4） μmol/L], （P 〈0.01 ）. Serum level of HCY in Gensini score 〉 40 group （25 ±6） μmol/L] was significantly higher than that in Gensini score 20-40 group （21 ±4） μmoL/L] and Gensini score 〈20 group （16±3）μmol/L], （P〈0.01）. Conclusions Levels of serum HCY are significantly higher in patients with ACS than those in normal group. Serum HCY is correlated with ACS coronary lesion account and severity of coronary lesions.