冠脉病变与血清同型半胱氨酸及脂蛋白（a）的相关性研究

目的:观察冠心病(CHD)患者冠状动脉病变程度与血清同型半胱氨酸(Hcy)和血清脂蛋白(a)[Lp(a)]水平间的相关性。方法:选择经冠状动脉造影确诊的CHD患者108例为CHD组,其中亚组:稳定型心绞痛(SAP)37例,不稳定型心绞痛(UAP)36例,急性心肌梗死(AMI)35例,另选择82例健康体检者为健康对照组,比较两组及CHD组内各亚组血清Hcy和Lp(a)水平,分析冠状动脉病变程度与血清Hcy、Lp (a)水平的相关性。结果:与健康对照组比较,CHD组血清Hcy[(7.1±2.1)μmol/L比(15.6±5.0)μmol/L]和Lp(a)[(122.6±20.4)mg/L比(220.2±42.6)mg/L]水平均显著升高(P均=0.001);且与SAP组比较,UAP组和AMI组血清Hcy[(12.5±4.0)μmol/L比(18.1±5.9)μmol/L、(20.1±6.0)μmol/L]和Lp(a)[(150.8±30.8)mg/L比(272.8±50.3)mg/L、(280.6±52.9)mg/L]水平及Gensini评分[(15.5±8.5)分比(50.6±11.2)分、(54.3±12.8)分]均显著升高(P均=0.001);Pearson相关分析显示,CHD患者冠状动脉病变程度与血清Hcy及Lp(a)水平呈显著正相关(r=0.582、0.663,P均=0.001)。结论:血清Hcy和Lp(a)水平与CHD冠状动脉病变程度呈正相关,联合检测之有助于了解病情,并指导治疗。

Correlation among serum levels of homocysteine,lipoprotein(a)and coronary artery disease

Objective:To observe correlation among serum levels of homocysteine(Hcy),lipoprotein(a)[Lp(a)]and severity of coronary artery disease in patients with coronary heart disease(CHD).Methods:A total of 108 CHD patients diagnosed by coronary angiography were selected as CHD group,including subgroups:37 cases with stable angina pectoris(SAP),36 cases with unstable angina pectoris(UAP)and 35 cases with acute myocardial infarction(AMI).Another 82 healthy subjects were regarded as healthy control group.Serum levels of Hcy and Lp(a)were compared between two groups and among CHD subgroups,and the correlation among serum levels of Hcy,Lp(a)and severity of coronary artery disease was analyzed.Results:Compared with healthy control group,there were significant rise in serum levels of Hcy [(7.1±2.1)μmol/L vs.(15.6±5.0)μmol/L]and Lp(a)[(122.6±20.4)mg/L vs.(220.2±42.6)mg/L]in CHD group,P=0.001 both;compared with SAP group,there were significant rise in serum levels of Hcy [(12.5±4.0)μmol/L vs.(18.1±5.9)μmol/L,(20.1±6.0)μmol/L],Lp(a)[(150.8±30.8)mg/L vs.(272.8±50.3)mg/L,(280.6±52.9)mg/L]and Gensini score[(15.5±8.5)scores vs.(50.6±11.2)scores,(54.3±12.8)scores]in UAP group and AMI group,P=0.001 all;Pearson correlation analysis indicated that severity of coronary artery disease was significant positively correlated with serum levels of Hcy and Lp(a)in CHD patients(r=0.582,0.663,P=0.001 both).Conclusion:Serum levels of Hcy and Lp(a)are significant positively correlated with severity of coronary artery disease in CHD patients,their combined detection is helpful to understand disease condition and guide clinical treatment.