老年冠心病与血浆同型半胱氨酸及其代谢相关因子

目的观察老年冠心病及糖尿病与血浆同型半胱氨酸及其代谢相关因子之间的关系。方法选择老年冠心病患者68例,其中伴发Ⅱ型糖尿病的16例为A组;无伴发Ⅱ型糖尿病52例为B组;选择22例健康老年人作为对照组C组。对受试者进行血浆同型半胱氨酸、叶酸和维生素B12定量测定。结果患病组老年血浆同型半胱氨酸值明显高于健康老年组,血浆Vit B12、叶酸值明显低于健康对照组,两组间比较有统计学意义(P<0.05),Ⅱ型糖尿病组(A组)血浆同型半胱氨酸值明显高于无糖尿病组(B组)(P<0.05),且A组VitB12和叶酸值明显低于B组(P<0.01),B组血浆同型半胱氨酸值高于C组,Vit B12明显低于C组(P<0.01),而叶酸两组间差别无统计学意义。患病组的同型半胱氨酸值和叶酸、VitB12呈明显的负相关,相关系数分别为-0.61和-0.49,P均<0.01。结论老年冠心病患者高同型半胱氨酸血症与动脉硬化、冠心病的发病及糖尿病胰岛素相对或绝对缺乏有密切关系,探讨老年人同型半胱氨酸的代谢规律对预防老年心脑血管疾病有重要意义。

Homocysteine and its metabolism correlation factors with coronary heart disease in the elderly

Objective To observe the relationship for plasm homocysteine(Hcy) and its metabolism correlative factors with coronary heart disease and diabetes.Methods In the elderly,the 68 patients diagnosed as coronary heart disease were divided into group A,16 cases suffering from type Ⅱ diabetes,and group B,52 cases not suffering from type Ⅱ diabetes.22 health persons were chosen as the control group(group C).All of the objects were determined of their plasm Hcy,folic acid and VitB12.Results Level of plasm Hcy in the patient group was much higher than that of group C,level of plasm folic acid and VitB12 in the patient group was much lower than that of group C(P<0.05).Level of plasm Hcy in the group A was much higher than that of group B,level of plasm folic acid and VitB12 in the group A was much lower than that of group B(P<0.05).Level of plasm Hcy in the group B was much higher than that of group C,level of plasm VitB12 in the group B was much lower than that of group C(P<0.05),there were no significant difference about the level of folic acid between group B and C.There was significant negative correlation between Hcy and folic acid and VitB_(12) in the group A and B.Conclusion Hyperhomocysteinemia is caused by insufficiency of folate and VitB12 as closely related with arteriosclerosis,coronary heart disease,diabetes in aged patients.