高同型半胱氨酸血症对急性冠状动脉综合征患病的作用及其机制探讨

目的 :探讨血浆同型半胱氨酸 (Hcy)与急性冠状动脉综合征的相关性及Hcy致急性冠状动脉综合征的病理机制。方法 :选择我院心内科住院患者 61例为急性冠状动脉综合征组 ,44例为稳定性心绞痛组及经有关检查排除冠心病者 3 2例为对照组 ,测定 3组患者血浆Hcy水平 ,同时测定血中内皮素 (ET)、一氧化氮 (NO)及一氧化氮合酶 (NOS)等水平。结果 :急性冠状动脉综合征组Hcy水平明显高于稳定性心绞痛组及对照组 ,有显著性差异 (P <0 0 5 )。多因素回归分析表明 ,Hcy为急性冠状动脉综合征的独立危险因素。急性冠状动脉综合征组患者的ET水平明显高于稳定性心绞痛组及对照组 ,而NO水平明显低于稳定性心绞痛组及对照组 ,均有极显著性差异 (P均 <0 0 1)。Hcy与ET呈正相关 ,而与NO、NOS呈负相关。结论 :Hcy与急性冠状动脉综合征独立相关。Hcy可能损伤血管内皮细胞 ,导致内皮功能失调。

Effects of Hyperhomocysteinemia on Acute Coronary Syndrome and Its Pathogenesis

Objective:To investigate the correlations between homocysteine(Hcy)and acute coronary syndrome(ACS)and the pathogenesis by Hcy. Method:The fasting plasma total levels of Hcy,endothelin(ET),nitric oxide(NO)and nitric oxide synthetase(NOS)were detected respectively. Results:The levels of Hcy in ACS group were significantly higher than those in the stable angina pectoris(SAP)group and control group( p <0 05).Based on multifactorial logistic regression analysis,Hcy was believed as an independent risk factor for ACS.Plasma ET levels were significantly higher in ACS patients than in SAP subjects and the controls( p <0 01),whereas serum NO levels were markedly lower in ACS patients than in SAP subjects and the controls( p <0 01).Hcy levels were positively correlated with ET,but negatively with NO and NOS. Conclusions:Plasma Hcy is correlated with ACS independently.The possible pathogenesis by Hcy is associated with the injury and dysfunction of vascular endotheliocytes.