血清尿酸、同型半胱氨酸、视黄醇结合蛋白4与冠心病的相关性分析

目的探讨血清同型半胱氨酸（Hcy）、尿酸、视黄醇结合蛋白4（RBP4）与冠心病的相关性。方法入院拟诊为冠心病的患者共603例，经冠状动脉造影确诊为冠心病的患者503例，根据临床特点分为心肌梗死组（MI组。n=84，包括急性和亚急性心肌梗死），不稳定型心绞痛组（UA组，n=312）和稳定型心绞痛组（SA组，n=107）。非冠心病100例作为对照组。检测并比较各组血清Hcy、尿酸、RBP4水平，采用Pearson作相关性分析，采用logistic多因素回归分析冠心病危险因素。结果血清Hcy、尿酸水平在不同分型的冠心病组均高于对照组（P〈0．05），且呈MI组〉UA组〉SA组〉对照组，各组间Hcy、尿酸比较差异有统计学意义（P〈0．05）；而RBP4在各组间差异无统计学意义（P〉0．05）。Hcy是冠心病的危险因素。Hcy、尿酸、RBP4均与吸烟史、TG、ApoAl相关，尿酸与Hcy、RBP4相关（P〈0．05或0．01）。结论Hcy、尿酸与冠心病的发病密切相关，其血清水平高低与病变的严重程度相一致，Hcy是冠心病的危险因素。

Correlation of serum homocysteine,uric acid and retinol -binding protein 4 with coronary heart disease

Objective To analyze the correlation of serum homocysteine（Hcy）, uric acid and retinol-binding protein4 （RBP4） with coronary heart disease （CHD）. Methods 503 cases with CHD diagnosed by coronary angiography were classified into MI group （n=84, including acute and subacute myocardial infarction）, unstable angina （UA） group （n=312） and stable angina （SA） group （n=107） based on their clinical characteristics. 100 cases without CHD were included as control group. Serum Hcy, uric acid and RBP4 were measured and their correlations were determined by Pearson test. The risk factors for CHD were analyzed by multivariate logistic regression. Results The level of Hcy and uric acid, but not RBP4, were significantly higher in MI,UA and SA groups than those in control group （P〈0.05）, ranked in the order of MI group〉UA group〉SA group 〉control group. Multivariate logistic regression analysis showed that Hcy was a risk factor for CHD. Hcy, uric acid and RBP4 were correlated to smoking, TG and ApoA1. Uric acid was correlated to Hcy and RBP4. Conclusion Hcy and uric acid are obviously associated with CHD. Their serum levels are consistent with the severity of CHD. Hcy is a risk factor for CHD.