同型半胱氨酸与冠脉病变程度及斑块的关系

目的探讨血浆同型半胱氨酸（Hey）水平与冠状动脉病变程度及斑块稳定性的关系。方法对200例可疑冠心病患者行冠状动脉造影，根据冠状动脉造影结果分为冠状动脉造影正常的对照组（54例）和冠心病组（146例）；冠心病组根据临床类型分为急性冠状动脉综合征组（ACS组，115例）和稳定型心绞痛组（SAP组，31例）。以Gensini积分评价动脉粥样硬化病变程度，以临床类型评价斑块稳定性。检查所有患者血浆Hcy、高敏C-反应蛋白（hs—CRP）等指标，分析Hey、hs—CRP与Gensini积分、斑块稳定性的关系。结果ACS组和SAP组Hcy水平均显著高于对照组[（28．8±6．5）mol／L比（10．2±4．1）mol／L，（16．3±5．7）mol／L比（10．2±4．1）mol／L，P均〈0．05]，而且随着冠状动脉病变Gensini积分的增加而逐渐升高；ACS组Hey水平较SAP组高（P〈0．05）。结论冠心病患者血浆同型半胱氨酸水平与冠状动脉粥样硬化病变程度明显相关，且与斑块稳定性呈正相关。

Relationships between homocysteine and severity of coronary atherosclerosis and stabmty of plaque

Objective To investigate the correlations between serum levels of homocysteine and the severity and stability of coronary atherosclerosis. Methods Coronary angiography （CAG） was performed in 200 patients who were suspected as having coronary artery disease（CAD）. According to the coronary artery changes and plaque characters in CAG, all patients were divided into control group （n=54） and CAD group （n=146）. According to the clinical types, the CAD patients were divided into acute coronary syndrome （ACS） group （n= 115 ） and stable angina pectoris （SAP） group （n=31）. The number of coronary Gensini＇s score was used for evaluate the severity of atherosclerosis. The clinical types was used for evaluate the stability of plaque. Hcy and hs-CRP were measured in all the patients. The correlation between serum Hcy with hs-CRP and number of Gensini＇s score, clinical types were analyzed. Results Hcy in CAD patients was significantly higher than that in control group [（28.8±6.5）mol/L vs （10.2±4.1）mol/L, （16.3±5.7）mol/L vs （10.2±4.1）mol/L, all P〈0.05], and increased with the increasing number of diseased coronary Gensini＇s score. Hcy in ACS group was higher than SAP group（P〈 0.05 ）. Conclusion CAD patients serum Hcy level is correlated with the severity of atherosclerosis and the stability of plaque.