补充VitB12和叶酸对冠心病患者血清同型半胱氨酸水平的影响

目的 观察不同类型冠心病患者血清同型半胱氨酸(Hcy)水平的变化,并探讨补充VitB12和叶酸对伴有高同型半胱氨酸血症(HHcy)的冠心病患者血清Hcy水平的影响.方法 选择151例经冠状动脉造影检查确诊的冠心病患者(CHD组)和120名健康体检者(正常对照组)作为研究对象,采用循环酶法检测血清Hcy,观察不同类型冠心病患者血清Hcy水平的变化.选择68例伴有HHcy的冠心病患者随机分为常规治疗组和补充VitB12组,治疗4周后观察患者血清Hcy水平的变化情况并评价冠心病病情是否好转.结果 CHD组共检出79例冠心病患者伴有HHcy(占49.62％),明显高于正常对照组(4.17％);CHD组患者血清Hcy水平(24.23±5.54)μmol/L]明显高于正常对照组(8.31±2.83)μmol/L];不同类型冠心病患者相比,SAP组、UAP组及AMI组血清Hcy水平和HHcy检出率均依次升高.伴有HHcy的冠心病患者治疗4周后,补充VitB12组患者血清Hcy水平明显下降,而常规治疗组患者血清Hcy水平下降不明显;两组患者冠心病病情好转率无统计学差异.结论 冠心病患者血清Hcy水平显著升高,且与临床类型相关;补充VitB12和叶酸可明显降低冠心病患者血清Hcy水平.

Effects of supplementation of VitB12 and folic acid on serum homocysteine level in patients with coronary heart disease

Objective To observe the serum homocysteine(Hcy) levels in patients with different kinds of coronary heart disease(CHD) and explore the effect of the supplementation of VitB12 and folic acid on serum homocysteine level in CHD patients complicated with hyperhomocysteinemia (HHcy).Methods 151 CHD patients diagnosed by coronary angiography were included in a CHD group and 120 healthy people were classified as a control group.Enzymatic cycling method was used to detect serum Hcy.The Hcy levels of patientswith different kinds of CHD is observed.68 CHD patients complicated with HHcy were chosen and randomly divided into a routine treatment group and a VitB12 group,supplemented with VitBl2.After 4 weeks' treatment,the patients' Hcy level was observed to evaluate whether the patients were getting better.Results 79 patients (49.62％) were detected with HHcy in the CHD group and only 5 (4.17％) in the control group.The Hcy level was (24.23±5.54) μmol/L in the CHD group and (8.31±2.83) μmol/L in the control group.The Hcy level and HHcy detection rate were increasing in the SAP group,UAP group,and AMI group.After 4 weeks' treatment for CHD patients complicated with HHcy,the serum Hcy level decrease markedly in the VitB12 group but not obviously in the routine treatment group;there was no statistical difference in the improvement rate between these two groups.Conclusions CHD patients' Hcy level significantly increases;Hcy level correlates with the clinical types of CHD;the supplementation of VitB12 and folio acid can markedly lower CHD patients' Hcy level.