血浆同型半胱氨酸、脂蛋白（a）水平与冠心病的相关性研究

目的探讨血浆同型半胱氨酸(HCY)、脂蛋白(a)[LP(a)]的变化与冠心病(CHD)的关系。方法将233例CHD患者分为三组,无症状型CHD组55例,稳定型心绞痛组95例,心肌梗死组83例,50名健康者作为对照组,同时根据冠脉造影进一步将观察对象分为一支病变组(93例),双支病变组(81例)和多支病变组(59例)分别在HITACHI-7600-020全自动生化分析仪上测定血浆Hcy及LP(a)的水平。结果冠心病患者血浆Hcy、LP(a)的水平均比健康对照组明显增高,二者有显著差异(P<0.01,P<0.05),急性心肌梗死组高于稳定型心绞痛组,稳定型心绞痛组高于无症状型CHD组;且血浆Hcy、LP(a)水平随病变支数增加而增高。结论CHD患者血浆Hcy、LP(a)水平明显增高,且与冠状动脉病变程度及冠脉病变支数呈正相关,是冠心病的独立危险因素。

Relationship Between Plasma Homocysteine,Lipoprotein and Coronary Heart Disease

Objective To study the relationship between levels of plasma homocystein(Hcy),lipoprotein [LP(a)] and severity of coronary heart disease(CHD).Methods Hcy and LP(a) levels were determined by HITACHI 7600-020 automatic biochemistry analyzer in 233 patients with CHD and 50 controls.Clinically,the 233 patients were categorized in 3 groups:asymptomatic group(n=55),stable angina(n=95),and myocardial infarction(n=83).The patients could also subclassified into 3 groups according to the numbers of occluded vessels demonstrated in coronary arteriogram:single vessel(n=93),double vessels(n=81) and multiple vessels(n=59).Results The levels of Hcy and LP(a) in patients with coronary arterial disease were significantly higher than those in controls(P<0.01,P<0.05).The levels of Hcy and LP(a) in patients with myocardial infarction were higher than those in patients with stable angina;and again higher than those in the asymptomatic patients.The more occluded vessel number,the higher level of Hcy and LP(a).Conclusions The plasma levels of Hcy and LP(a) are significantly elevated in CHD patients and closely relate to the severity of the disease process.They may be independent risk factors of coronary heart disease.