急性冠状动脉综合征致病危险因素分析

目的：探讨急性冠状动脉综合征中致病危险因素的变化情况及其意义。方法：对107例行冠脉造影的急性冠脉综合征(急性心肌梗死及不稳定型心绞痛)与其它类型冠心病的血管阻塞积分进行计算，将其血糖、血脂等进行比较。结果：急性冠脉综合征患者中有高血压、冠心病、糖尿病家族史和(或)伴高血压、糖尿病者48例(62.3％)。其C反应蛋白(CRP)、血糖、血脂紊乱情况均较其它型冠心病更为明显。在急性心肌梗死与冠心病组中，血管阻塞积分与年龄明显相关。在急性心肌梗死组中，吸烟者的发病年龄与HDL明显低于不吸烟者，而红细胞压积则明显高于不吸烟者。结论：急性冠脉综合征的发生与遗传、吸烟、血糖、血脂代谢以及CRP的异常等因素参与有关。     

老年人冠心病危险因素分析

目的　综合评价冠心病危险因素对老年人冠心病的影响。方法　对 35 7例行选择性冠状动脉造影检查的老年患者进行回顾性分析。结果　 35 7例行冠状动脉造影检查的患者中确诊冠心病 2 32例 ,阳性率 6 5 4%。单因素分析 ,增龄、男性、吸烟、饮酒、高血压、糖尿病、体重增加、总胆固醇及低密度脂蛋白升高、高密度脂蛋白降低易致老年冠心病事件发生。多因数回归分析 ,性别、年龄、吸烟及LDL/HDL C为冠心病事件发生的独立危险因素。结论　与年轻患者比较老龄患者的心血管事件发生的危险性更高。因此对危险因素的预防和控制可为老龄患者带来的绝对获益更大。     

冠心病危险因素在女性早发冠心病临床诊断中的价值

目的 探讨冠心病危险因素在诊断女性早发冠心病中的价值。方法 以选择性冠状动脉造影为标准，对472例临床拟诊为冠心病、年龄〈65岁女性患者的主要冠心病危险因素（年龄、糖尿病、高脂血症及高血压）和临床诊断符合率的关系进行分析。结果 472例临床诊断女性早发冠心病的符合率为52．12％；无危险因素时冠心病临床诊断符合率仅24．72％，即3／4患者误诊，伴1个危险因素时便骤升到48．63％，伴3个危险因素时达80．00％。冠心病危险因素越多，临床诊断符合率越高（P〈0．01）。≥45岁女性的诊断符合率则显著高于〈45岁女性（53．97％与34．09％，P〈0．05）。有糖尿病史、高脂血症、高血压患者诊断符合率均分别显著高于无糖尿病、无高脂血症、无高血压患者（分别为75．45％与45．03％．64．77％与36．06％，56．44％与46．63％；P〈0．01或P〈0．05）。结论 冠心病危险因素与女性早发冠心病临床诊断准确率关系密切。关注危险因素有助于减少冠心病的临床误诊。     

血清E-选择素在冠心病中的变化及其意义

目的探讨血清E-选择素在冠心病患者中的变化及其意义。方法冠心病患者70例，其中稳定型心绞痛（SA组）24例、不稳定型心绞痛（UA组）24例和急性心肌梗死（AMI组）22例；同时选择30例冠状动脉造影阴性者作为对照组。Gensini积分法评价冠状动脉病变程度，将70例冠心病患者分为两个亚组：A组22例（Gensini积分1～20），B组48例（Gensini积分〉20）。酶联免疫吸附法检测E-选择素水平，并进行比较。结果血清E-选择素水平冠心病各组均显著高于对照组（均为P〈0．01），冠心病各组间亦有显著性差异（均为P〈0．05）；B组血清E-选择素显著高于A组（P〈0．05）。结论E-选择素可能参与了冠心病的发病过程，且与冠状动脉粥样硬化程度有关。     

超敏C-反应蛋白与血脂联合评估冠心病危险性

目的 探讨超敏C-反应蛋白与血脂联合评估冠心病危险性的临床应用价值。方法 对375名健康体检者、397名冠脉造影阳性组患者和23名心肌梗死组患者的血脂和hsCRP值进行分析。计算危险系数。并对健康组、冠心病组及两性间的危险系数进行统计学分析和评估。结果 不同年龄组（除30-39岁和40-49岁组外）血脂、hsCRP和危险系数均有显著差异，冠脉造影阳性患者的危险系数显著高于健康对照组。但冠脉造影阳性组间危险系数无显著差异。结论 危险系数与动脉粥样硬化的程度无关。健康男女间的危险系数无显著性差异。危险系数评估标准整合了引起动脉粥样硬化的内因-血浆脂蛋白和外在表现-hsCRP两方面的实验数据。反映动脉粥样硬化的临床变化及发生冠心病的实际危险性,消除了冠心病发病危险性评估的性别差异,利于临床的应用。     

Issues in minority health: atherosclerosis and coronary heart disease in African Americans

Cardiovascular disease (in particular, CHD) is the leading cause of death in the United States for Americans of both sexes and of all racial and ethnic backgrounds. African Americans have the highest overall CHD mortality rate and the highest out-of-hospital coronary death rate of any ethnic group in the United States, particularly at younger ages. Contributors to the earlier onset of CHD and excess CHD deaths among African Americans include a high prevalence of coronary risk factors, patient delays in seeking medical care, and disparities in health care. The clinical spectrum of acute and chronic CHD in African Americans is the same as in whites; however, African Americans have a higher risk of sudden cardiac death and present clinically more often with unstable angina and non-ST-segment elevation myocardial infarction than whites. Although generally not difficult, the accurate diagnosis and risk assessment for CHD in African Americans may at times present special challenges. The high prevalence of hypertension and type 2 diabetes mellitus may contribute to discordance between symptomatology and the severity of coronary artery disease, and some noninvasive tests appear to have a lower predictive value for disease. The high prevalence of modifiable risk factors provides great opportunities for the prevention of CHD in African Americans. Patients at high risk should be targeted for intensive risk reduction measures, early recognition/diagnosis of ischemic syndromes, and appropriate referral for coronary interventions and cardiac surgical procedures. African Americans who have ACSs receive less aggressive treatment than their white counterparts but they should not. Use of evidence-based therapies for management of patients who have ACSs and better understanding of various available treatment strategies are of utmost importance. Reducing and ultimately eliminating disparities in cardiovascular care and outcomes require comprehensive programs of education and advocacy(Box 4) with the goals of (1) increasing provider and public awareness of the disparities in treatment; (2) decreasing patient delays in seeking medical care for acute myocardial infarction and other cardiac disorders; (3) more timely and appropriate therapy for ACSs; (4) improved access to preventive, diagnostic, and interventional cardiovascular therapies; (5) more effective implementation of evidence-based treatment guidelines; and (6) improved physician-patient communications.     

Ischemic heart disease and its relation to basic risk factors among the rural population

Using standard methods of the epidemiological survey the authors examined a 10% randomized sample of men aged 40 to 59 years living in a rural area. A total of 533 persons were entered into the study (a 82% coverage). Based on the epidemiological data the coronary heart disease (CHD) prevalence was established to amount to 8.8% according to the enlarged criteria (angina pectoris of effort according to the WHO cardiological questionnaire; the definite myocardial infarction with the Minnesota code categories 1.1-1,2.7; the painless pattern of CHD with categories 4.1-4.2 and 5.1-5.2 without 3.1 and 3.3; possible myocardial infarction 1.2.8, 1.3; possible myocardial ischemia 4.3, 5.3; the arrhythmic pattern 6.1, 7.1, 8.3; myocardial ischemia with left ventricle hypertrophy 4.1-4.2, 5.1-5.2 with 3.1, 3.3; possible myocardial infarction in the anamnesis in accordance with the WHO cardiological questionnaire). It was also found that in persons aged 50 to 59 years, CHD occurs 2 times as frequently as in those aged 40 to 49 years (13.1 and 5.8%, respectively). The prevalence of CHD was discovered to be about 3.5 times higher in the presence of arterial hypertension and overweight and 2 to 2.5 times higher in the presence of hypercholesterolemia, hypo-alpha-cholesterolemia and hypertriglyceridemia. A high correlation was noted between arterial hypertension and overweight and the prevalence of CHD before (r = 0.174 and r = 0.198, respectively) and after elimination of risk factors (r = 0.14 and r = 0.14). Among CHD patients, one risk factor was noted in 21.8%, two in 39.1%, three and more in 23.9%, whereas among persons without CHD in 32.4, 10.9 and 3.5%, respectively.     

超敏C反应蛋白在冠心病中的表达特性

目的探讨血清超敏C反应蛋白(hsCRP)在冠心病中的表达特性。方法随机选取115例经冠脉造影证实的冠心病患者,包括稳定型心绞痛(SAP)39例,不稳定型心绞痛(UAP)34例,急性心肌梗塞(AMI)42例,50例健康人作为对照组。在OlympusAU2700全自动生化分析仪上应用乳胶增强免疫透射比浊法测定血清中hsCRP的浓度,并分析治疗前后hsCRP水平的差异。结果冠心病患者中hsCRP浓度与对照组相比明显增高,差异具有统计学意义(P<0.01)。AMI组hsCRP水平明显高于UAP组,UAP组hsCRP水平明显高于SAP组,均有统计学意义(P<0.01)。冠心病各组的hsCRP水平在治疗前后比较有统计学意义(P<0.01)。结论冠心病患者血清hsCRP水平显著增高,提示冠心病患者可能存在炎症反应。检测hsCRP对冠心病的辅助诊断、疗效观察及预后判断具有重要价值。     

平板运动试验结合动态心电图对冠心病的诊断价值

目的 探讨24h动态心电图(DCG)及平板运动试验(TET)在冠心病诊断中的应用,并对冠状动脉造影(CAG)与平板运动试验相关指标进行分析.方法 选择有不典型胸痛或可疑冠心病患者149例,在CAG前行DCG和TET检查,分析DCG及TET两种检查方法各自对冠心病的诊断价值,以及两者联合对冠心病的诊断价值,并根据CAG的结果分为冠心病组和非冠心病组,记录TET运动开始后第1分钟心率的增加量(△HR1min)及运动后收缩压(SBP)恢复等指标,与冠状动脉造影结果相比较.结果 DCG诊断冠心病的敏感性为61.90％,特异性为66.15％;TET诊断冠心病的敏感性为78.57％,特异性为70.77％;两者联合并联试验时敏感性为95.23％,特异性为55.38％,阳性预测值为73.39％,阴性预测值为90.00％;敏感性、阴性预测值较单独DCG、TET提高;两者联合串联试验时敏感性为52.38％,特异性为95.38％,阳性预测值为93.62％,阴性预测值为60.78％,特异性、阳性预测值较单独DCG、TET提高;冠心病患者男性比例高于非冠心病组[72例(85.71％)与35例(53.85％),x2=18.385,P＜0.01],收缩压恢复比异常增高[ 46.43％( 39/84)与15.38％( 10/65),x2=16.001,P＜0.01].结论 DCG与TET两者结合可提高对冠心病诊断的敏感性和特异性,冠心病组患者运动后收缩压恢复延迟,该指标可作为冠心病诊断的辅助标准.     

动态心电图筛查睡眠呼吸暂停综合征在冠心病中的应用

目的应用动态心电图(DCG)观察冠心病(CHD)患者中睡眠呼吸暂停综合征(SAS)的发生情况,分析SAS与CHD及其危险因素之间的关系。方法选取因胸痛于本院心内科住院并行冠状动脉造影检查的患者共166例,根据造影结果分为CHD组和对照组。所有患者均进行DCG检查,并应用DCG筛查SAS。结果 166例患者中确诊CHD100例(CHD组),66例除外CHD(对照组)。CHD组的男/女性别比例高于对照组,差异有统计学意义(P0.05),年龄、腹围、糖尿病患病率、估计的呼吸暂停低通气指数(Est.AHI)、SAS发生率亦明显高于对照组,差异有统计学意义(P0.01)。CHD组有38.0%合并SAS,而对照组SAS的发生率仅为18.2%。Logistic回归分析显示Est.AHI水平、性别、年龄与CHD发病独立相关,且危险性从大到小依次为Est.AHI水平、年龄和性别。结论 CHD患者中SAS的发生率较高,SAS是CHD的独立危险因素;应用DCG筛查CHD患者中的SAS是可行的,具有一定的临床实用价值。     

Study based on the WHO Monika program on the connection between psychosocial risk factors and ischemic heart disease in men aged 25-64 in Novosibirsk

AIM: To study correlations between coronary heart disease (CHD) and psychosocial risk factors. MATERIAL AND METHODS: CHD affected more frequently workers engaged in hard physical labour, in poorly educated persons; the least CHD morbidity was recorded in managers and highly educated persons. CHD males think of their health much worse than males free of CHD. The former smoked much more before CHD diagnosis, but when CHD comes they quit and reduce smoking much more frequently. This fact explains why smokers are encountered among CHD patients two times less frequently than in CHD-free males. In spite of stronger motivation for adequate diet, CHD males changed their nutrition pattern only in 3.7%. CHD males sleep worse: good sleep was registered in CHD-free males two times more frequently. Psychological risk factors such as personal anxiety, sleep disorders were reported much more frequently in CHD patients proving the fact of social stress involvement in development of CHD. So-called coronary behavior was observed in both groups of males with the same rate. Thus, the coronary behavior is not associated with CHD. CONCLUSION: Development of CHD is associated not with the behavior but its components (depression, anxiety, etc.).     

Characteristic analysis of clinical coronary heart disease and coronary artery disease concerning young and middle-aged male patients

BACKGROUNDCoronary heart disease (CHD) is a type of coronary atherosclerotic heart disease. In recent years, the incidence of CHD has been increasing annually, with an increasing number of young patients. Severe CHD may cause severe myocardial ischemia or myocardial necrosis, which in turn may cause myocardial infarction and related complications that seriously affect the life and health of the patient.AIMTo examine the coronary arteries and clinical features of young and middle-aged male patients with CHD.METHODSFrom February 2019 to January 2020, 110 male CHD patients admitted to our hospital were selected as research subjects and were divided into two groups by age: middle-aged group (n = 55) and young group (n = 55). The coronary arteries and clinical features of the patients were compared.RESULTSThere were no significant differences in dyslipidemia, stroke history, high-density lipoprotein cholesterol, or triacylglycerol (P > 0.05) between the two groups. In the young group, age, diabetes, hypertension, smoking history, body mass index, family history of CHD, drinking history, fibrinogen, low-density lipoprotein cholesterol, total cholesterol, and single-vessel disease were higher than those in the middle-aged group. Correspondingly, serum uric acid, hyperuricemia, myocardial infarction, Gensini score > 50, collateral circulation, multivessel disease, double vessel disease, involvement of the right coronary artery, and involvement of the left main coronary artery were lower in the young group than in the middle-aged group. The middle-aged group mainly suffered from a high Gensini score, implicating multiple arteries, whereas the young group was mainly affected by single-vessel disease. The between-group difference was significant (P < 0.05).CONCLUSIONIn CHD attacks, multiple coronary arteries are implicated in middle-aged male patients and single-vessel disease in young male patients.     

不同性别静息心率与冠心病的关系

目的观察不同性别静息心率与冠心病的关系。方法观察208例入选者的静息心率,据冠状动脉造影结果将其分为对照组及冠心病组。结果男性冠心病组静息心率（77．7±12．5次／min）显著高于对照组（69．1±9．0次／min）（P〈0．05）;女性冠心病组静息心率（76．25±10．8次／min）与对照组（72．2±11．9次／min）无显著差异（P〉0．05）。结论静息心率与冠心病的关系因性别不同而存在一定差异,其中男性静息心率与冠心病相关性较女性强。     

Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study.

OBJECTIVE--To determine coronary heart disease (CHD) incidence among dyslipidemic subjects with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the effect of lipid-modifying treatment on serum and lipoprotein lipids and the CHD incidence in these patients. RESEARCH DESIGN AND METHODS--Of the 4081 men participating in the Helsinki Heart Study, a coronary primary prevention trial with gemfibrozil in middle-aged men with high non-high-density lipoprotein (HDL) cholesterol (greater than 5.2 mM; 200 mg/dL), 135 had NIDDM at entry. The incidence of definite myocardial infarction and cardiac death and changes in serum and lipoprotein lipids were determined during the 5-yr trial in the NIDDM patients and compared with those observed in nondiabetic trial participants. RESULTS--Compared with nondiabetic subjects, NIDDM patients had lower HDL cholesterol (P less than 0.001), higher triglyceride concentration (P less than 0.0001), and greater body mass index (P less than 0.001), there were more hypertensive patients (P less than 0.001) among them. The incidence of myocardial infarction and cardiac death was significantly higher among diabetic than nondiabetic participants (7.4 vs. 3.3%, respectively, P less than 0.02). CHD incidence in the gemfibrozil-treated diabetic men (n = 59) was 3.4% compared with 10.5% in the placebo group (NS). In multivariate analysis, diabetes (P less than 0.05), age (P less than 0.0001), smoking (P less than 0.0001), low HDL cholesterol (P less than 0.05), and high low-density lipoprotein cholesterol (P less than 0.005) were independently related to CHD incidence. Gemfibrozil-induced serum and lipoprotein lipid changes in diabetic patients were similar to those observed in nondiabetic subjects. CONCLUSIONS--Compared with similarly dyslipidemic nondiabetic subjects, patients with NIDDM are at markedly increased risk of CHD. This elevated risk can be somewhat reduced by gemfibrozil.     

Coronary heart disease in women: update 2008

Coronary heart disease (CHD) remains the leading cause of mortality for US women, responsible for almost 250,000 deaths annually. Preventive heart-health behavioral changes by women and aggressive coronary risk reduction can decrease the number of women disabled and killed by CHD. Angina is the predominant initial and subsequent presentation of CHD in women; categorization of chest pain and risk stratification of women assume pivotal roles. A robust evidence-based algorithm can guide cardiovascular imaging techniques to evaluate women with suspected myocardial ischemia to detect those with worsened survival. Restricted functional capacity (<5 METs) is a consistent marker of worsened prognosis. Younger women have substantially higher mortality rates than men following myocardial infarction and coronary bypass surgery. Although these women have more comorbidity and risk factors, other issues including biological differences, treatment differences, and psychosocial factors require management strategies tailored to the unique needs of women.     

不同性别人群的冠心病主要危险因素分析

目的分析冠心病(CHD)主要危险因素年龄、高血压、高脂血症、糖尿病在男性和女性人群中的差别。方法经冠状动脉造影检查确诊的冠心病患者608例,其中合并高血压350例,高血脂158例,糖尿病222例。分析男女冠心病发病的年龄及危险因素在不同年龄段的分布。结果冠心病发病平均年龄男性组(55.2±9.9)岁与女性组(64.5±10.1)岁比较有差异(P=0.04),在<50岁亚组中,男性较女性发病率高(P<0.05)。女性组危险因素中高血压病、糖尿病、高脂血症的发生率均明显高于男性组(均P<0.05)。女性高血压在70~79岁亚组较60~69岁亚组下降;糖尿病在男性和女性70~79岁亚组较60~69岁亚组都下降;高脂血症在男性70~79岁亚组构成比下降。冠心病人高血压和糖尿病在男性和女性各年龄亚组构成比差异有统计学意义(P<0.01);高血脂年龄构成比差异无统计学意义(P=0.134)。结论年龄、高血压、高脂血症、糖尿病在男性和女性冠心病患者中有差别。     

Coronary heart disease risk equivalence in diabetes depends on concomitant risk factors

OBJECTIVE: Diabetes has been defined as a coronary heart disease (CHD) risk equivalent, and more aggressive treatment goals have been proposed for diabetic patients. RESEARCH DESIGN AND METHODS: We studied the influence of single and multiple risk factors on the 10-year cumulative incidence of fatal and nonfatal CHD and cardiovascular disease (CVD) in diabetic and nondiabetic men and women, with and without baseline CHD or CVD, in a population (n = 4,549) with a high prevalence of diabetes. RESULTS: In both sexes, diabetes increased the risk for CHD (hazard ratio 1.99 and 2.93 for men and women, respectively). Diabetic men and women had a 10-year cumulative incidence of CHD of 25.9 and 19.1%, respectively, compared with 57.4 and 58.4% for nondiabetic men and women with previous CHD. The pattern was similar when only fatal events were considered. Diabetic individuals with one or two risk factors had a 10-year cumulative incidence of CHD that was only 1.4 times higher than that of nondiabetic individuals (14%). However, the 10-year incidence of CHD in diabetic subjects with multiple risk factors was >40%, and the incidence of fatal CHD was higher in these subjects than in nondiabetic subjects with previous CHD. Data for CVD showed similar patterns, as did separate analyses by sex. CONCLUSIONS: Our results and comparisons with other available data show wide variation in the rate of CHD in diabetes, depending on the population and existing risk factors. Most individuals had a 10-year cumulative incidence >20%, but only those with multiple risk factors had a 10-year cumulative incidence that was equivalent to that of patients with CHD. Until more data are available, it may be prudent to consider targets based on the entire risk factor profile rather than just the presence of diabetes.     

Coronary heart disease incidence and cardiovascular mortality in Busselton with reference to glucose and insulin concentrations

In the 1966 study of the population of Busselton, Australia, blood sugar and serum insulin levels were measured one hour after an oral glucose load, in addition to the conventional cardiovascular risk factors. The six-year incidence of coronary heart disease (CHD) and the 12-yr mortality from CHD and from all cardiovascular diseases is described in relation to the initial baseline variables measured using the upper 20th percentile values (age-specific and sex-specific) to define the risk ratios. In younger subjects (ages less than 60 yr), elevated blood pressure levels for both sexes (risk ratios from 2.9 to 5.2) and elevated serum cholesterol concentrations for males (risk ratios from 3.0 to 3.3) were strong predictors of cardiovascular risk. In men aged 60 to 69 yr, those with upper range one-hour serum insulin concentrations showed marked associations with the six-year incidence of CHD, the 12-yr mortality from CHD, and the 12-yr mortality from all cardiovascular diseases (risk ratios were 2.0, 2.3, and 2.4, respectively). The relationship of elevated serum insulin and cardiovascular mortality persisted when males of all ages were analyzed, and it appeared to be independent of the other major risk factors. In females, no association between serum insulin and CHD or cardiovascular disease could be found. Although the age and sex specific upper 20th percentile values for one-hour blood sugar concentrations showed a low grade association in patients with subsequent cardiovascular disease end points, more noticeable risk ratios were demonstrated at the higher blood sugar level of 200 mg/100 ml or greater (in the age group 60 yr and over, risk ratios were 2.2 in males and 2.6 in females.     

Prevention of coronary heart disease in type 2 diabetes

Patients with diabetes without a prior myocardial infarction are at a similar risk of coronary heart disease (CHD) events as non-diabetic subjects with a prior myocardial infarction. Furthermore, prognosis after the first myocardial infarction is worse in diabetic compared to non-diabetic patients. Therefore, management of cardiovascular risk factors in subjects with diabetes should be as vigorous as in patients with known CHD who have had a myocardial infarction. Randomised controlled trials have shown that efficacy of cholesterol lowering and antihypertensive therapy in type 2 diabetes is at least as effective as in non-diabetic subjects in preventing macrovascular disease. Antiplatelet therapy with aspirin reduces the risk of CHD events in high-risk patients and the benefit is similar in subjects with and without diabetes. Improved glycaemic control has a modest beneficial effect on CHD risk. There is residual excess risk of CHD in type 2 diabetes, which is not explained by traditional cardiovascular risk factors. Insulin resistance may partly mediate this. Prediabetic subjects who are insulin resistant have more adverse levels of triglycerides, high density lipoprotein (HDL)-cholesterol and blood pressure than those who are insulin sensitive. Moreover, factors associated with insulin resistance are significant predictors of CHD events in subjects with diabetes, in addition to conventional risk factors. The thiazolidinedione, pioglitazone, improves glycaemia and insulin sensitivity in hyperglycaemic patients. It also improves insulin and triglyceride levels and lowers blood pressure. Thiazolidinediones have been found to have vasculo-protective effects in both acute and chronic vascular injury in animal models. For prevention of CHD in type 2 diabetes a multi-factorial approach should be considered, including improved glycaemic control, aggressive management of dyslipidaemia and hypertension, anti-platelet therapy, reduction of insulin resistance and use of agents that improve insulin sensitivity.     

同型半胱氨酸与老年冠心病的相关性研究

目的探讨血浆同型半胱氨酸(Hcy)水平与老年冠心病(CHD)的发生及严重程度的相关性。方法选择30例健康老年人(对照组)和70例老年冠心病患者(CHD组),其中老年冠心病组又分为26例心肌梗死型冠心病(AMI)、24例不稳定性心绞痛型冠心病(UAP)及20例稳定性心绞痛型冠心病(SAP),分别测定其血浆Hcy水平,同时测定其血脂水平包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)。结果 CHD组Hcy水平明显高于对照组(P<0.01),3组间Hcy水平比较AMI>UAP>SAP(P<0.05),同时CHD组中对血浆Hcy与TG、TC、LDL-C、的相关分析结果显示,血浆Hcy与其无明显相关(P>0.05)。结论血浆Hcy水平是老年冠心病的独立危险因素之一,且升高水平与冠脉病变严重程度相关。