急性心肌梗死患者血浆同型半胱氨酸水平与冠状动脉病变的相关性研究

目的检测急性心肌梗死(AMI)患者血浆同型半胱氨酸的水平,观察高同型半胱氨酸血症(HHcy)与冠状动脉病变的相关性以及与其他危险因素的相关性,以探讨HHcy在心血管疾病中的作用。方法选择AMI患者50例,对照组为冠状动脉正常者共30例。检测血浆同型半胱氨酸(Hcy)、血糖(GLU)、血脂、C反应蛋白(CRP)、脑钠肽(BNP)。行心脏彩超检查记录E/A,左室射血分数(LVEF)。行冠状动脉造影记录冠状动脉病变支数、狭窄程度。结果冠状动脉三支病变组Hcy水平高于对照组〔(34.69±10.31)μmol/L,(9.57±2.57)μmol/L,P<0.05〕。冠状动脉三支病变组血浆Hcy水平高于双支病变组和单支病变组〔(46.78±2.42)μmol/L,(34.88±3.39)μmol/L,(22.36±3.24)μmol/L〕,冠状动脉双支病变组血浆Hcy水平高于单支病变组〔(34.88±3.39)μmol/L,(22.36±3.24)μmol/L〕,差异均有统计学意义(P<0.01)。AMI组中IRA狭窄程度100%组血浆Hcy水平高于100%>IRA≥95%组〔(37.27±10.06)μmol/L,(31.39±9.89)μmol/L,P<0.05〕(1例IRA狭窄程度<75%除外)。AMI组血浆Hcy与BNP呈正相关(r=0.162,P<0.05),与LVEF呈负相关(r=-0.235,P<0.05),与E/A无相关(r=0.072,P>0.05)。结论 (1)AMI患者血浆Hcy水平明显升高。(2)AMI患者血浆Hcy水平与冠状动脉病变支数、狭窄程度呈正相关。(3)HHcy可以作为冠心病的一个危险因素,与其他危险因素共同在冠心病的发生、发展中起重要作用。

Correlation on Plasma Homocysteinemia with Coronary Artery Lesion in Acute Myocardial Infarction

Objective Observe the correlation on plasma homocysteinemia with coronary artery lesion and other risk factors in acute myocardial infarction.The aim of design was exploring how hyperhomocy-steinemia work in coronary artery disease.Methods 80 patinets were selected.50 of them are the AMI group with acute myocardial infarction.30 of them are the control group with normal coronary.All patients were detected homocysteine,blood glucose,blood lipids,C reactive protein,brain natriuretic peptide in the biochemical room.Recorded the ratio about A peak and E peak,left ventricular ejection fraction by checking echocardiography.Recorded coronary disease vessel number count and coronary stenosis degree by checking coronary angiography.Results The plasma homocysteine levels of the AMI group was higher than the levels of the control group((34.69±10.31)μmol/L,(9.57±2.57)μmol/L,P<0.05).Between the two groups there was a significant difference,and P<0.05.The plasma homocysteine levels of patients with tripe-vessel was higher than the levels of patients with double-vessel and single-vessel((46.78±2.42)μmol/L,(34.88±3.39)μmol/L,(22.36±3.24)μmol/L).The plasma homocysteine levels of patients with double-vessel was higher than the levels of patients with single-vessel((34.88±3.39)μmol/L,(22.36±3.24)μmol/L).Showed different changes with the different number of coronary vessel disease.The plasma homocysteine levels of patients with completely blocked coronary was higher than that of patients without completely blocked coronary((37.27±10.06)μmol/L,(31.39±9.89)μmol/L,P<0.05).The plasma homocysteine levels had positive correlation with brain natriuretic peptide in patients with acute myocardial infarction(P<0.05).The plasma homocysteine levels had negative correlation left ventricular ejection fraction in patients with acute myocardial infarction(P<0.05).The plasma homocysteine levels had no relationship with E/A in patients with acute myocardial infarction(P>0.05).Conclusion(1)The plasma homocysteine levels of patients with acute myocardial infarction were significantly increased.(2)The plasma homocysteine levels had positive correlation with the number and degree of stenosis vessel in acute myocardial infarction patients.(3)As a risk factor for coronary heart disease,homocysteine and other risk factors play an important role in coronary heart disease.