同型半胱氨酸引起血小板聚集率升高对心血管疾病的影响

目的：研究高血压或（和）冠心病（ CHD）患者血同型半胱氨酸（ Hcy）升高是否引起血小板聚集率升高，以及对心血管疾病的影响。方法回顾性分析338例高血压或（和） CHD患者的临床资料，分析Hcy与CHD、稳定性心绞痛（ SA）、不稳定型心绞痛（ UA）、急性心肌梗死（ AMI）、心力衰竭（ HF）、冠脉病变支数、再住院率以及血小板聚集率的相关性。结果高Hcy患者CHD的发生率明显高于低Hcy患者（84.7％ vs 67.3％，P＜0.001），其中高Hcy患者UA、AMI和HF的发生率均较低Hcy患者显著升高（44.1％ vs 27.4％，33.5％ vs 21.4％，41.2％vs 18.5％，P均＜0.05）；高Hcy的CHD患者三支病变较低Hcy患者显著升高（53.5％ vs 32.7％，P＝0.001），同样，其再住院率也显著升高（42.4％vs 19.5％，P＜0.001）。高Hcy患者AA 0（0～4）Ω高于低Hcy患者0（0～1）Ω，差异有统计学意义（ P＝0.003）。结论 Hcy升高导致血小板聚集率升高，最终使心血管事件发生率升高，甚至预后不良。

Effect on the platelet aggregation elevation induced by homocysteine on cardiovascular diseases

Objective To investigate the correlation between elevated homocystein ( Hcy) and the platelet aggre-gation, and its influence on cardiovascular diseases .Methods This retrospective study was conducted in 338 patients with hypertension and/or coronary heart disease (CHD).The correlations between Hcy concentration and CHD , stable angina (SA), unstable angina(UA), acute myocardial infarction (AMI), heart failure (HF), the severity of coronary artery lesion, the re-hospitalization rate or platelet aggregation were analyzed .Results The frequencies of CHD , UA, AMI and HF were 84.7%, 44.1%, 33.5% and 41.2%, respectively, in high Hcy group (Hcy≥13 mmol/L) versus 67.3%, 27.4%, 21.4%and 18.5%, respectively, in low Hcy group (Hcy<13 mmol/L, P<0.05).In addition, the frequency of three-vessel lesions were 53.5% and 32.7% in high Hcy group and low Hcy group , respectively ( P=0.001), and the re -hospitalization rateswere 42.4% in high Hcy group and 19.5% in group low Hcy group ( P <0.001).The AA in high Hcy group was significantlyhigher than that in low Hcy group (2.66 ±4.06 vs 1.20 ±2.74, P<0.001).Conclusion As Hcy concentration elevating, the platelet aggregation is rising, which increases the morbidity of CHD and adverse prognosis .