血浆同型半胱氨酸与冠脉病变支数及冠心病不同类型的关系

目的探讨血浆同型半胱氨酸(homocysteine,Hcy)水平与冠状动脉病变支数及冠心病不同类型之间的关系。方法用高效液相色谱法对118例行选择性冠脉造影的患者进行血浆Hcy水平的测定。冠脉造影显示至少一支血管狭窄≥50%者为冠心病组(78例),血管狭窄<50%者诊为非冠心病组(40例)。冠心病患者进一步分为单支病变组(19例),双支病变组(27例),三支病变组(32例)。结果冠心病患者血浆Hcy水平显著高于非冠心病组(P<0.01),多支病变组血浆Hcy水平明显高于非冠心病组(P<0.01),单支病变组略高于非冠心病组(P<0.05),急性心肌梗死患者血浆Hcy水平明显高于非急性心肌梗死患者(P<0.01)。结论血浆Hcy水平升高是冠状动脉病变的危险因素,Hcy增高越显著,则冠脉病变支数越多。Hcy水平升高与冠状动脉的急性病变有关。

Relationship among serum homocysteine, type of coronary heart disease and the branches of coronary arteriopathy

Objective To explore the significance of homocysteine(Hcy)in pathogensis of coronary heart disease(CHD) and the relationship among serum homocysteine,type of CHD and the branch of coronary arteriopathy.Methods One hundred and eighteen subjects who underwent coronary angiography from June 2004 to January 2007 in our hospital were recruited in this study.Patients with 50% stenosis in at least one of the three coronary vessels were defined as CHD by angiography(n=78).Patients with <50% stenosis in one coronary vessel constituted the non CHD group.CHD cases were divided into single-vessel(n=19),double-vessel(n=27) and triple-vessel group(n=32).Plasma homocysteine was measured before angiography in all subjects.Results Mean Plasma homocysteine level was significantly higher in coronary patiens than in controls(P<0.01).Hcy level in multiple-vessel group was significantly higher than in negative group(P<0.01).The single-vessel group presented slightly higher Hcy level than negative group.(P<0.05).Conclusion Mild elevation of serum homocysteine level is an independent risk facror.Higher level of homocysteine is associated with increased number of conronary arteries with sterosis.