急性冠脉综合征患者血清同型半胱氨酸水平测定的临床意义

目的]测定急性冠脉综合征（ACS）患者血清同型半胱氨酸（Hcy）水平,探讨血清Hcy水平与ACS严重程度的关系。方法]将108例ACS患者分为不稳定性心绞痛（UA）组51例和急性心肌梗塞（AMI）组57例,其中75例根据冠状动脉造影结果又分为冠脉病变一支、二支、三支及以上组。以50例健康体检者作为对照组。测定各组血清Hcy水平,并进行统计学分析。结果]血清Hcy水平UA组（15.40±5.51）μmol/L、AMI组（20.39±6.43）μmol/L,与对照组（10.21±3.61）μmol/L比较差异有显著性意义（P〈0.01）,UA组与AMI组比较,差异有显著性意义（P〈0.01）。通过单因素方差分析,冠脉病变一支组（12.63±5.20）μmol/L、二支组（15.40±2.11）μmol/L和三支及以上组（21.56±5.89）μmol/L之间血清Hcy水平比较差异有显著性意义（F=23.803,P〈0.01）,且随病变支数增加,血清Hcy水平逐渐升高,提示患者血清Hcy水平与冠状动脉受累支数具有正相关性。对照组和一支组（P〈0.05）、一支组和二支组（P〈0.05）、二支组和三支及以上冠脉病变组（P〈0.01）之间Hcy水平比较差异均有显著性意义。结论]ACS患者血清Hcy水平显著高于正常人群,并与冠状动脉受累支数及疾病严重程度有正相关性。测定血清Hcy水平可能对ACS的预防和治疗监测具有重要临床意义。

Clinical significance of measurement of serum homocysteine level in patients with acute coronary syndrome

Objective] To measure the level of serum homocysteine(Hcy) in patients with acute coronary syndromes(ACS) and to discuss the relationship between serum Hcy level and severity of ACS.Methods] One hundred and eight ACS patients were divided into two groups:51 cases of unstable angina(UA) and 57 cases of acute myocardial infarction(AMI).Among them 75 ACS patients were divided into one-branch,two-branch and three-branch and above three-branch groups according to the number of affected coronary branches verifi...