幽门螺杆菌感染对冠心病患者血清生化水平的影响

目的探讨幽门螺杆菌(Hp)对冠心病患者血清生化水平病的影响,了解Hp感染与冠心病发生之间可能的关系。方法 156例经冠状动脉造影确诊为冠心病的患者为实验组,210例排除冠心病的患者为对照组。检测实验组和对照组的血生化指标、血清Hp IgG、血清同型半胱氨酸和血清高敏C反应蛋白(hs-CRP)浓度等。结果实验组的HpIgG的阳性率为71.89%,高于对照组(32.38%)(χ2=55.63,P<0.05);实验组血清甘油三酯、胆固醇和高密度脂蛋白浓度均高于对照组(P均<0.05);实验组Hp IgG阳性者血清甘油三酯、低密度脂蛋白和高密度脂蛋白浓度均高于实验组Hp阴性者;实验组血清同型半胱氨酸和hs-CRP的浓度均高于对照组(t=13.82,45.92,P<0.05);实验组Hp IgG阳性者血清同型半胱氨酸和hs-CRP的浓度高于实验组Hp阴性者(t=8.29,9.44,P<0.05)。结论 Hp感染能够通过增加同型半胱氨酸水平、影响正常的脂质代谢来影响冠心病的发生和发展。     

多种指标联合检测对老年高血压早期肾损害的诊断价值

目的 探究血清同型半胱氨酸(Hcy)、尿微量清蛋白/肌酐比值(ACR)和动态脉压指数(PPI)联合诊断老年性高血压早期肾损害的效能。方法 选取高血压伴早期肾损害患者100例,根据尿检结果分为尿蛋白阳性组(n=56)和尿蛋白阴性组(n=44),选取同期于门诊检查体检者50例作为健康对照组,检验各组血清Hcy水平及尿ACR,同时行动态血压检测,计算PPI,对比3项指标单独检测及联合检测诊断老年高血压患者早期肾损害效能。结果 阳性组和阴性组的血清Hcy、尿ACR及PPI均明显高于对照组(P<0.05),且阳性组与阴性组有统计学差异(P<0.05);阳性组与B、C两组血清Hcy及尿ACR阳性率对比差异有统计学意义(P<0.05),阴性组血清Hcy阳性率明显高于对照组(P<0.05);二项Logistic回归模型和受试者工作特征(ROC)曲线分析构建血清Hcy、尿ACR及PPI联合诊断模型,结果显示联合诊断模型的诊断效能显著优于单项检测(P<0.05)。结论 血清Hcy、尿ACR及PPI联合诊断可提高老年高血压患者早期肾损害的诊断价值,同时建议对老年高血压患者进行早...     

幽门螺杆菌感染与血清炎症因子及Hcy水平相关性研究

[目的]研究幽门螺杆菌(Hp)感染与血清炎症因子及同型半胱氨酸(Hcy)水平的相关性,探讨其临床意义。[方法]~(14)C尿素呼气试验的165例患者,将其分成Hp阳性组(82例)和Hp阴性组(83例),对2组血清中的炎症因子——白细胞介素-18、肿瘤坏死因子-α、高敏C-反应蛋白的水平及Hcy水平进行检测,比较2组患者的差异;并对Hp阳性组中经治疗后Hp转阴者进行治疗前后的以上指标比较。[结果]Hp阳性组患者血清炎症因子及Hcy水平均明显高于Hp阴性组,差异有统计学意义(P0.05);Hp阳性组中Hp转阴者治疗后血清炎症因子及Hcy水平均明显低于治疗前,差异有统计学意义(P0.05)。[结论]Hp感染可使血清相关炎症因子升高,进而诱发其他相关性疾病。     

细胞毒素相关蛋白毒力型幽门螺杆菌感染与冠心病患者血清炎性因子及同型半胱氨酸水平的相关性研究

目的:探讨幽门螺杆菌(HP)及细胞毒素相关蛋白毒力型HP(HP-Cag A)感染对冠心病患者血清炎性因子及同型半胱氨酸(Hcy)水平影响以及HP-Cag A感染与冠心病的相关性。方法:应用酶联免疫吸附分析法测定105例冠心病患者(冠心病组)和76例同期住院非冠心病患者(对照组)的血清HP特异性IgG抗体及其CagA特异性IgG抗体;采用乳胶增强散射免疫比浊法测定血清高敏C反应蛋白(hs-CRP);采用化学发光法测定血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和Hcy水平,并比较HP感染的冠心病患者与非HP感染患者之间的差异,以及HP-CagA-IgG阳性患者与HP-CagA-IgG阴性患者之间的差异。应用多元Logistic回归分析危险因素对冠心病的影响,用调整后的比值比(OR)和95%可信区间(CI)评估HP抗体阳性对患冠心病的危险性。结果:冠心病组与对照组HP-IgG抗体的阳性率分别为52.3%和35.5%,差异有统计学意义(P0.05);冠心病组血清hs-CRP、TNF-α、IL-6和Hcy水平高于对照组,差异有统计学意义(P0.05);冠心病组HP-IgG阳性患者中,HP-CagA-IgG阳性患者hs-CRP、TNF-α、IL-6和Hcy血清浓度水平高于HP-CagA-IgG阴性患者(P均0.05)。应用Logistic多元回归分析,在排除其他传统因素后,HP-IgG阳性和HP-CagA-IgG阳性对患冠心病存在相对危险性(OR=2.278,3.297;95%CI:1.20~4.32,1.50~7.27;P=0.012,0.003)。结论:冠心病的发生可能与HP感染有关系,HP-CagA感染可能通过刺激机体产生更多的炎性因子和Hcy,加快冠心病的发生、发展,是冠心病的危险因素之一。     

幽门螺杆菌感染与冠心病患者血脂代谢的关系

目的 探讨冠心病(CHD)患者幽门螺杆菌(Hp)感染的发生状况及其与血脂代谢的关系.方法 采用酶联免疫吸附法检测78例CHD患者及30例健康对照者血清抗Hp抗体及抗Hp细胞毒素相关基因蛋白A(Hp-CagA)抗体水平,分析其阳性率与患者血脂水平的关系.结果 冠心病组血清抗Hp抗体及抗Hp-CagA抗体阳性率明显高于健康对照组(P<0.01).冠心病组中Hp抗体阳性患者血清胆固醇、甘油三酯及低密度脂蛋白包括载脂蛋白A1和载脂蛋白B水平明显高于Hp抗体阴性患者,而高密度脂蛋白却低于Hp抗体阴性患者(P<0.05).结论 Hp感染可能会通过影响机体脂质代谢,促进动脉粥样硬化(AS)的形成,进而诱发CHD.     

冠心病患者幽门螺杆菌感染与胱抑素C、同型半胱氨酸、血脂关系探讨

[目的]探讨冠心病患者幽门螺杆菌（Hp）感染与胱抑素C、同型半胱氨酸、血脂水平变化的相关性.[方法]选择2012年8月～2012年12月于我院收治的冠心病患者53例,另选择55例健康体检者为对照组.分别采用酶联免疫吸附法（ELISA）检测Hp IgG、循环酶法检测Hcy以及免疫比浊法检测Cys C表达水平,并检测血脂,分析Hp感染与血清Cys C、Hey、血脂表达变化之间的关系.[结果]冠心病组Hp IgG阳性率与对照组比较,差异无统计学意义;血清TC、TG、LDL-C、Cys C、Hey的表达水平均明显高于对照组（P＜0.05）,而冠心病组HDL-C表达水平明显低于对照组（P＜0.05）.Hp感染阳性冠心病患者的血清TC、TG、LDL-C、Cys C、Hey表达水平均明显高于Hp感染阴性患者（P＜0.05）,而HDL-C表达水平显著低于Hp感染阴性患者（P＜0.05）.[结论]Hp感染与冠心病本身的发生没有显著相关性,但Hp感染可能通过对Cys C和Hcy表达以及血脂代谢水平的影响而促进冠心病的发展和演进.     

冠心病患者幽门螺杆菌感染与血清MMP-9水平及冠状动脉病变的相关性

目的探讨幽门螺杆菌(HP)和细胞毒素相关蛋白毒力型HP(HP-CagA)感染对冠心病患者血清基质金属蛋白酶9(MMP-9)水平的影响以及HP-CagA感染与冠心病冠状动脉病变的相关性。方法选择冠心病患者105例,其中急性心肌梗死(AMI) 35例,不稳定型心绞痛(UAP) 35例,稳定型心绞痛(SAP组) 35例,选择同期住院非冠心病(NCA)患者35例,应用酶联免疫吸附法检测血清HP特异性Ig G抗体阳性率、Cag A特异性Ig G抗体阳性率及MMP-9水平,并与冠状动脉造影Gensini评分进行相关性分析。比较HP感染的冠心病患者与非HP感染患者之间的差异,以及HP-CagA-IgG阳性患者与阴性患者之间的差异。结果各组血清MMP-9水平差异有统计学意义,其中AMI组UAP组SAP组NCA组(P均0.05);与NCA组比较,AMI组、UAP组及SAP组Gensini评分均增大(P均0.05);各组血清MMP-9水平与Gensini评分之间有明显的相关性(P均0.05)。SAP组、UAP组、AMI组及NCA组HP-IgG抗体的阳性率分别为40.0%、57.1%、74.3%和28.6%,其中AMI组UAP组SAP组NCA组(P均0.05);各组HP-IgG阳性患者的MMP-9水平均高于HP-IgG阴性患者(P均0.05);各组血清HP-IgG抗体的阳性率与Gensini评分之间有明显的相关性(P均0.05); SAP组、UAP组、AMI组及NCA组HP-CagA-IgG抗体的阳性率分别为17.1%、31.4%、40.0%和11.4%,其中AMI组UAP组SAP组NCA组(P均0.05);各组HP-CagA-IgG阳性患者的MMP-9水平均高于HP-CagA-IgG阴性患者(P均0.05);各组血清HP-CagA-IgG抗体的阳性率与Gensini评分之间有明显的相关性(P均0.05);其中血清MMP-9水平在HP-IgG(+) Cag A-IgG(+)亚组HP-IgG(+) Cag AIg G(-)亚组HP-IgG(-) Cag A-IgG(+)亚组(P均0.05);血清HP-IgG抗体的阳性率及血清HP-CagA-IgG抗体的阳性率均与血清MMP-9水平及Gensini评分之间有明显的相关性,尤其以血清HP-CagA-IgG抗体的阳性率与血清MMP-9水平及Gensini评分之间关系最密切(均P0.05)。结论冠心病的发生发展可能与HP感染,尤其与HPCag A感染有关,其可能是通过诱导内皮细胞大量分泌MMP-9所致,未来可能能作为预测冠状动脉病变程度的新指标。     

Hp感染及血清PCT、G-17在参与介导老年慢性萎缩性胃炎病理过程中的作用

目的 探讨幽门螺旋杆菌(Hp)感染及血清降钙素原(PCT)、胃泌素(G)-17在参与介导老年慢性萎缩性胃炎(CAG)病理过程中的作用。方法 选取老年CAG患者96例为观察组，同期选取诊断为老年慢性非萎缩性胃炎(CNAG)患者92例为对照组，可通过¹³C呼气试验检测Hp,采用酶联免疫吸附试验检测血清PCT、G-17水平，分析Hp感染及血清PCT、G-17在老年CAG病理发展中的作用。结果 观察组Hp阳性感染率与血清PCT水平高于对照组，血清G-17水平低于对照组，差异有统计学意义(P<0.05)。CAG患者Hp感染阳性者血清PCT水平高于Hp感染阴性者，Hp感染阳性者血清G-17水平低于Hp感染阴性者，差异有统计学意义(P<0.05)。不同病情程度比较，中度萎缩性胃炎组Hp感染率最高，重度次之，组内Hp感染阳性率差异有统计学意义(P<0.05)。不同病情严重程度血清PCT、G-17水平比较，随着胃黏膜萎缩程度加重，血清PCT水平逐渐上升，血清G-17水平逐渐下降，各指标组内比较差异均有统计学意义(P<0.05)。CAG患者中Hp感染阳性率与血...     

幽门螺杆菌感染及其毒力与急性心肌梗死、血浆纤维蛋白原及血栓素B2的关系

目的　探讨幽门螺杆菌 (Hp)感染及其不同毒力与心肌梗死的关系。 方法　测定 5 1例急性心肌梗死 (AMI组 )和 42例陈旧性心肌梗死 (OMI组 )患者及 3 1例冠脉造影正常者 (对照组 )的Hp特异性抗体 (HpIgG、HpIgM )及其细胞毒素相关蛋白特异性抗体浓度 ,并同步观察血浆纤维蛋白原 (Fg)、血栓素B2 (TXB2 )变化及其与Hp感染的相关性。结果　AMI组HpIgG、HpIgM阳性率及平均浓度 (或OD值 )明显高于对照组 (P <0 .0 5 ) ;校正冠心病危险因素前、后 ,HpIgG阳性与AMI均具有相关关系。AMI组Fg、TXB2 明显高于对照组、OMI组。AMI组中Hp阳性者Fg、TXB2 明显高于Hp阴性者 (P <0 .0 5 )和OMI组中Hp阳性者 (P <0 .0 0 1) ;调整冠心病的危险因素前、后 ,IgG与Fg均呈正相关 (P <0 .0 5 )。 结论　Hp感染与AMI、Fg、TXB2 之间存在明显的相关性 ,不同毒力的Hp感染与冠心病心肌梗死的关系无显著性差异     

冠心病患者血管内皮细胞生长因子水平与幽门螺杆菌感染情况的关系

目的研究冠状动脉粥样硬化性心脏病(冠心病)患者血清中血管内皮细胞生长因子(VEGF)水平与幽门螺杆菌(Hp)感染情况的关系。方法选取郑州大学第一附属医院心内科于2017年9月至11月收治的80例冠心病患者及同期80名健康体检者作为研究对象,将其分为研究组和对照组,对比两组的VEGF水平和Hp感染情况。结果研究组的Hp-IgG阳性率对照组,阴性率低于对照组(P0.05);研究组的Hp-IgG检测阳性血清VEGF水平和Hp-IgG检测阴性血清VEGF水平均高于对照组(P0.05)。结论冠心病患者血清VEGF水平与Hp感染情况具有密切的关系,冠心病患者的血清VEGF水平与Hp感染几率均高于正常人群,通过对VEGF水平与Hp-IgG进行检测,能够对冠心病的病情诊断及发展提供相关检测指标,对冠心病治疗具有积极的意义。     

Homocysteine and progression of coronary artery disease

BACKGROUND: Hyperhomocysteinemia is one of the newly recognised risk factors of coronary artery disease (CAD). The role of hyperhomocysteinemia in the development of atherosclerosis has been controversial. AIM: To assess homocysteine (Hcy) plasma concentration in patients with CAD and to correlate Hcy level with some cardiovascular risk factors. METHODS: The study group consisted of 150 males aged <55 years (mean age 49.5+/-5.7 years) with stable CAD. Lipid and carbohydrate profiles as well as Hcy, folic acid and vitamin B(12) serum concentration were assessed, and correlated with such cardiovascular risk factors as cigarette smoking, hypertension, obesity and a history of myocardial infarction. RESULTS: Mean Hcy plasma concentration was 11.81+/-3.75 micro mol/L. In patients with Hcy >11.21 micro mol/L (median value) a lower level of folic acid and vitamin B12 as well as reduced ejection fraction and glomerular filtration rate were found when compared to patients with Hcy level <11.21 micro mol/L. In addition, creatinine concentration, mean patient's age, proportion of patients who smoked cigarettes and the number of affected coronary arteries were significantly higher in patients with an increased level of Hcy. The Hcy plasma concentration positively correlated with the progression of hypertension, creatinine level and the number of coronary vessels with stenosis. A significant negative correlation between Hcy and folic acid as well as vitamin B12 concentrations was documented. In patients with a three-vessel CAD, Hcy concentration was 12.46+/-3.85 micro mol/L and was significantly higher (p<0.03) compared with patients with a less advanced CAD. In the group of patients with diabetes the mean Hcy concentration increased with the number of affected coronary vessels (p<0.02) and reached the highest values in patients with a three-vessel CAD (15.38+/-7.28 micro mol/L). CONCLUSIONS: There is a significant relationship between homocysteine plasma concentration and the incidence as well as progression of CAD. This association is particularly evident in patients with diabetes.     

幽门螺杆菌感染与冠心病的相关性

目的:探讨幽门螺杆菌(helicobacter pylori,Hp)感染与冠心病之间的关系。方法:研究对象分为:正常对照组(88例)和冠心病组(175例),正常对照组为冠状动脉造影(CAG)正常者;冠心病组经CAG证实冠状动脉狭窄程度超过50%,且排除Hp感染根治史或者恶性肿瘤的病史。我们通过胃十二指肠镜活检制作胃窦部组织切片,War-thin-starry银染色确定Hp感染。结果:两组间观测指标性别、年龄、吸烟和高密度脂蛋白胆固醇(HDL-C)差异具有统计学意义。正常对照组中28例(32%)和冠心病组73例(42%)伴有Hp感染,但差异不具有统计学意义。随访行经皮冠状动脉介入治疗的冠心病患者82例,半年复查CAG,59例Hp阴性的患者有21例(36%)出现新的冠状动脉病变或支架内再狭窄,23例Hp阳性的患者有12例(52%)出现新的冠状动脉病变或支架内再狭窄,两组间差异不具有统计学意义。结论:本研究没有明确Hp感染与冠心病的关系,有待进一步研究。     

Plasma homocysteine levels in patients with early coronary artery stenosis and high risk factors

The aim of this study was to study the relationship between plasma homocysteine (Hcy), folic acid, vitamin B12 and early coronary artery disease (early-CAD) and high coronary risk factors. The plasma Hcy levels of 58 cases with early-CAD and 31 subjects without CAD were measured using high-performance liquid chromatography (HPLC) with fluorescence detection. Plasma folic acid and Vitamin B12 levels were measured with radioassay method. The plasma Hcy level was significantly higher in the early-CAD patients than in the controls [(13.7 +/- 5.1) micromol/L vs (10.3 +/- 5.7) micromol/L]. The plasma folic acid and Vitamin B12 levels were significantly lower in the early-CAD patients than in the controls. The plasma Hcy level was higher in patients with more than 3 risk factors of CAD than in patients with 1 or 2 risk factors and in the controls [(17.3 +/- 5.1) micromol/ L vs (12.9 +/- 4.8) micromol/L, (7.8 +/- 2.5) micromol/L]. Other than gender, all classical coronary risk factors were related to the elevated Hcy level. Hcy levels were elevated in patients with early-CAD and with high risk factors. Hyperhomocysteinemia plays an important role in the pathogenesis of CAD.     

Coronary artery disease patient's first degree relatives may be at higher risk for atherosclerosis

Our aim was to investigate the relationship between the serologic status concerning Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp), Cytomegalovirus (CMV) and high sensitive C-reactive protein (hsCRP) in coronary artery disease (CAD) patient's first degree relatives, which remain an unrevealed issue in literature. We studied 192 CAD patients (pts), 140 CAD-patient first degree relatives (CAD-R) and 192 controls with no evidence of obstructive CAD. Seropositivity for Cp IgG (71 vs 50, p=0.090), Hp IgA (98 vs 59, p=0.06), Hp IgG (77 vs 55, p=0.09), CMV IgG (62 vs 44, p=1.00), Ct IgG (7 vs 6, p=0.78) was not significantly higher in CAD-pts compared to CAD-R. However, seropositivity to Cp IgA (154 vs 96, p=0.020) and hsCRP (114 vs 65, p=0.014) were significantly higher in CAD-pts compared to CAD-R. Further differences between CAD-R and controls were significant for all seropositive groups and hsCRP. Therefore, this study adds to the strong evidence of association of Cp specific IgA and hsCRP with CAD and CAD-R is at higher risk for disease progression.     

冠心病患者心率变异性及血浆同型半胱氨酸水平与冠脉病变程度有相关性

目的 探讨冠心病患者心率变异性(HRV)、血浆同型半胱氨酸(Hcy)水平与冠脉病变程度的相关性。方法 我院心内科住院冠脉造影确诊为冠心病患者278例,根据Gensini评分法将其分为冠状动脉狭窄轻度组（76例）、中度组（109例）和重度组（93例）。常规检测各组血浆Hcy水平,以及进行24h动态心电监测,并记录HRV指标,分析比较各组间HRV指标和血浆Hcy水平的差异以及分析HRV和血浆Hcy水平与冠脉病变严重程度之间的相关性。结果 Hcy水平随着Gensini评分值升高而升高,轻、中、重度3组间比较差异具有统计学意义(P<0.05);3组间SDNN、SDANN、rMSSD、PNN50、LF/HF等参数差异具有统计学意义(P<0.05),且随着冠脉病变程度的加重,HRV指标数值逐渐降低;Pearson相关分析显示SDNN,SDANN,rMSSD,pNN50,LF/HF与Gensini评分值呈负相关（均P<0.05）,Hcy与Gensini评分呈正相关（P=0.01）。Logistic多因素回归分析表明,Hcy、HRV是加重患者冠状动脉病变的独立相关因素。结论 冠心病患者HRV及血浆Hcy水平与冠脉病变程度有相关性。     

血浆同型半胱氨酸与系统性红斑狼疮关系的探讨

目的探讨系统性红斑狼疮(SLE)与血浆同型半胱氨酸(Hcy)间的关系,并分析影响SLE患者Hcy的代谢因素.方法 60例SLE患者和正常对照组45例,测定并分析血浆Hcy水平与叶酸、维生素B12、IgG、IgA、IgM、C3、C4、C反应蛋白(CRP)、血沉(ESR)各指标之间的关系.结果 (1)SLE组血浆Hcy、IgG、IgA、IgM、CRP、ESR水平均显著高于正常对照组(P<0.05);叶酸、维生素B12 、C3、C4均显著低于正常对照组(P<0.05).(2)SLE组患者Hcy与IgG、IgA、IgM、CRP呈正相关,与叶酸、维生素B12、C3、C4水平呈负相关(P<0.05),与ESR无相关性.(3)正常组血浆Hcy浓度与各指标无相关性.结论 Hcy水平升高与SLE密切相关,SLE患者普遍有高Hcy血症,血浆Hcy的检测对于SLE病人有临床应用价值.     

Nontraditional atherosclerotic risk factors and extent of coronary atherosclerosis in patients with combined impaired fasting glucose and impaired glucose tolerance

Partially inconsistent data exist on mutual relations between nontraditional atherosclerotic risk factors, including the magnitude of insulin resistance (IR), as well as on their relevance for atherogenesis in the metabolic syndrome. Subjects exhibiting combined impaired fasting glucose and impaired glucose tolerance (IFG/IGT) are exposed to an exceptionally high risk for atherogenesis and development of type 2 diabetes mellitus. Because of islet Beta-cell dysfunction, the usefulness of commonly used indices of IR is limited in IFG/IGT. Our aim was to assess the relationship between extent of angiographic coronary artery disease (CAD) and nontraditional atherosclerotic risk factors (including IR by a clamp-based golden standard method) in IFG/IGT. Fifty-three subjects (32 men, 21 women; mean age, 55 +/- 11 years) with stable angina, preserved left ventricular systolic function, and IFG/IGT were divided into 3 groups: group A (no coronary stenoses >50%, n = 22), group B (1-vessel CAD, n = 15), and group C (2/3-vessel CAD, n = 16). Insulin sensitivity was quantified by a hyperinsulinemic euglycemic clamp technique and expressed as M. M value, plasma homocysteine (Hcy) level, and asymmetric dimethyl-L-arginine (ADMA)/L-arginine ratio were independent determinants of CAD extent as shown by forward stepwise discriminant function analysis. Compared with group A (M = 32.7 +/- 9.3 micromol/kg fat-free mass [FFM] per minute; Hcy, 8.1 +/- 1.4 micromol/L), lower M and higher Hcy levels were found in group B (M = 16.9 +/- 8.2 micromol/kg FFM per minute, P < .001; Hcy, 11.2 +/- 2.9 micromol/L, P = .003) and C (M = 16.4 +/- 7.8 micromol/kg FFM per minute, P < .001; Hcy, 12.8 +/- 3.9 micromol/L, P < .001). The ADMA/L-arginine ratio was increased in group C (0.0078 +/- 0.0011) compared with group A (0.0063 +/- 0.0013, P = .03) and B (0.0058 +/- 0.0012, P = .01). Multivariate correlates (P < .05) of plasma Hcy concentrations were M (beta = -.34 +/- .12, P = .008), creatinine clearance (beta = -.23 +/- .10, P = .03) and fasting insulin (beta = .25 +/- .12, P = .04). This indicates an additive contribution of IR, plasma Hcy, and elevated ADMA/L-arginine ratio to the extent of angiographic CAD in combined IFG/IGT.     

对氧磷酶基因多态性及血浆同型半胱氨酸硫内酯复合物水平与冠心病的关系

目的探讨对氧磷酶(PON)基因多态性(PON1 T-107C、PON2 C311S)及血浆同型半胱氨酸(Hcy)、同型半胱氨酸硫内酯(HTL)复合物水平与冠心病发病的关系。方法对203例经冠状动脉造影证实为冠心病的患者及117例经冠状动脉造影证实无冠状动脉病变的对照者进行研究,采用竞争性 ELISA 法测定血浆 HTL 复合物水平;采用高压液相色谱法测定血浆 Hcy 的水平;采用多聚酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)分析 PON 基因中 PON1 T-107C 和 PON2 C311S基因多态性。结果冠心病组血浆 Hcy 和 HTL 复合物水平明显高于对照组(P<0.01);PON1 T-107C 基因型与等位基因频率分布在冠心病组与对照组间比较差异无统计学意义(P>0.05);而PON2 C311S 的 SS 基因型分布在冠心病组低于对照组(P<0.05),但等位基因频率分布两组间差异无统计学意义(P>0.05);当两位点的等位基因 T、S 同时出现时(即 CT/TF+CS/SS 基因型)血浆 Hcy及 HTL 复合物水平较 CC+CS/CC 或 CT+CC 基因型明显降低[Hcy(11.83±4.76)μmol/L 与(15.32±10.32)μmol/L;HTL(24.36±9.30)U/ml 与(32.05±10.44)U/ml],差异有统计学意义(P<0.05)。冠心病合并2型糖尿病组与冠心病无糖尿病组及对照组相比,PON2基因型分布差异有统计学意义,冠心病合并2型糖尿病患者中 C 等位基因频率明显增高(P<0.05)。结论血浆 Hcy 和 HTL 复合物水平升高可能是冠心病发病的独立危险因素,PON1 T 等位基因和 PON2 S 等位基因同时出现可能在动脉粥样硬化形成过程中起到保护作用,而 PON2 C311S 多态性的 C 等位基因存在可能与冠心病患者合并2型糖尿病的几率增高相关。     

同型半胱氨酸与冠脉病变程度及斑块的关系

目的探讨血浆同型半胱氨酸（Hey）水平与冠状动脉病变程度及斑块稳定性的关系。方法对200例可疑冠心病患者行冠状动脉造影,根据冠状动脉造影结果分为冠状动脉造影正常的对照组（54例）和冠心病组（146例）;冠心病组根据临床类型分为急性冠状动脉综合征组（ACS组,115例）和稳定型心绞痛组（SAP组,31例）。以Gensini积分评价动脉粥样硬化病变程度,以临床类型评价斑块稳定性。检查所有患者血浆Hcy、高敏C-反应蛋白（hs—CRP）等指标,分析Hey、hs—CRP与Gensini积分、斑块稳定性的关系。结果ACS组和SAP组Hcy水平均显著高于对照组[（28．8±6．5）mol／L比（10．2±4．1）mol／L,（16．3±5．7）mol／L比（10．2±4．1）mol／L,P均〈0．05],而且随着冠状动脉病变Gensini积分的增加而逐渐升高;ACS组Hey水平较SAP组高（P〈0．05）。结论冠心病患者血浆同型半胱氨酸水平与冠状动脉粥样硬化病变程度明显相关,且与斑块稳定性呈正相关。     

冠心病患者同型半胱氨酸与C反应蛋白P选择素的相关性研究

目的探讨冠心病患者体内血浆同型半胱氨酸(Hcy)及C反应蛋白(CRP)、P选择素(PS)表达的变化及其相关性。方法收集2006年1月至7月广西医科大学第一附属医院心内科经冠状动脉造影(CAG)确诊冠心病患者44例(冠心病组),以CAG阴性患者22例为对照组,所有入选对象在冠状动脉造影前抽血测定血浆Hcy、CRP及血小板PS的表达。结果冠心病组患者Hcy、CRP、PS表达均明显增高,与对照组比较差异有显著性意义(P<0.05);冠心病组Hcy与CRP呈正相关(r=0.355,P<0.05),Hcy与PS的表达呈正相关(r=0.439,P<0.05)。结论Hcy、CRP、PS在冠心病的发生、发展中起重要作用;冠心病组Hcy与CRP、PS的表达呈正相关,降低冠心病患者的Hcy是防治冠心病的重要途径。