同型半胱氨酸水平对冠脉病变严重程度及支架置入后MACCE发生率的影响

目的:分析同型半胱氨酸(Hcy)水平对冠心病患者冠脉病变严重程度及采取支架置入治疗后的主要不良心脑血管事件(MACCE)发生率的影响。方法:120例冠心病(CHD)患者,按照是否合并高Hcy水平被分成:CHD组,CHD+高Hcy组,均为60例,采用SYNTAX评分评价冠脉病变程度,对两组冠脉病变严重程度和支架置入后的MACCE发生率进行分析。结果:与CHD组比较,CHD+高Hcy组支架置入数(1.63±0.73)枚比(2.45±0.87)枚]、冠脉病变血管数(1.73±0.63)个比(2.25±0.70)个]及SYNTAX得分(25.90±5.88)分比(33.03±8.29)分]均显著增加(P均=0.001);在一年随访中,CHD+高Hcy组MACCE总发生率显著高于CHD组(23.33%比6.67%,P=0.011)。结论:同型半胱氨酸高水平和冠心病者冠脉病变严重程度存在一定关系,高水平同型半胱氨酸可能增加心脑血管不良事件发生率,临床需积极采取有效防治措施。

Influence of homocysteine level on coronary disease severity and incidence rate of MACCE after stent implantation

Objective:To analyze influence of homocysteine(Hcy)level on coronary disease severity and incidence rate of major adverse cardio-and cerebrovascular events(MACCE)after stent implantation in patients with coronary heart disease(CHD).Methods:The 120 CHD patients were divided into complicated CHD group(n=60)and CHD+ high level Hcy group(n=60)according to complicated high Hcy level or not.SYNTAX score was used to assess coronary disease extent,and coronary disease severity and incidence rate of MACCE after stent implantation were analyzed in two groups.Results:Compared with CHD group,there were significant rise in number of implanted stents(1.63±0.73)vs.(2.45±0.87)],number of diseased coronary vessels(1.73±0.63)vs.(2.25±0.70)vs.]and SYNTAX score(25.90±5.88)scores vs.(33.03±8.29)scores]in CHD+ high level Hcy group,P=0001 all;in one-year follow-up,total incidence rate of MACCE in CHD+ high level Hcy group was significantly higher than that of CHD group(23.33% vs.6.67%,P=0.011).Conclusion:Higher level Hcy is related with coronary disease severity in CHD patients.Higher level Hcy may increase incidence rate of MACCE,therefore,effective preventive and therapeutic measure should be performed in clinic.