急性冠脉综合征与同型半胱氨酸的关系研究

目的 通过测定急性冠脉综合征( ACS)患者血清同型半胱氨酸(Hcy)的水平,探讨ACS与Hcy的相关性.方法 将95例ACS患者分为不稳定型心绞痛组(UA)(40例)和急性心肌梗死组(AMI)(55例)并与30名冠脉造影正常者进行对照,测定各组Hcy值.同时根据冠脉造影结果将观察组分为单支病变组(28例),双支病变组(36例)以及多支病变(31例)三组,并进行统计学分析.结果 ACS患者血清Hcy水平明显高于健康对照组(P＜0.01),AMI组高于UA组(P＜0.05)；双支病变组高于单支病变组(P＜0.05),多支病变组Hcy高于双支病变组(P＜0.05),多支病变组明显高于单支病变组(P＜0.01).结论 ACS患者血清Hcy水平显著高于健康人群,并且Hcy水平与冠脉病变严重情况呈正比,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.

Study on the relationship between Acute Coronary Syndrome and serum homocysteine

Objective To discuss the relationship between serum homocysteine（Hcy） level and severity of acute coronary syndrome（ACS） through measuring the level of serum Hcy in the patients with ACS.Methods 95 patients who were diagnosed ACS were divided into two groups：40 cases of unstable angina（UA） and 55 cases of acute myocardial infarction（AMI）.30 individuals were chosen as normal control（NC）.In addition,according to the results of coronary angiography,the same 95 patients were further divided into three subgroups which were single-vessel disease（28cases）,double-vessel disease（36cases） and multi-vessel disease（31cases）.Level of serum Hcy was measured in all groups.Results Serum Hcy level of ACS patients was significantly higher than NC group（P＜0.01）.The level of serum Hcy in AMI group was significantly higher than that in UA group（P＜0.05）.The Hcy level in the multi-vessel disease group,double-vessel disease group and single-vessel disease group were increased in turn,and the difference of pairwise comparison was statistically significant（P＜0.05）.Conclusion The serum Hcy level has relationship with the severity of coronary lesions and is directly proportional to the number of coronary artery lesions.The result suggests that the level of serum Hcy maybe play an important role in the prevention,diagnosis,treatment and monitoring of ACS.