同型半胱氨酸与冠心病诊断类型的关系

目的　探讨血浆同型半胱氨酸 (Hcy)、血脂浓度与冠状动脉病变严重程度的关系。方法　对 88例行冠状动脉造影的患者检测血浆同型半胱氨酸、血脂 ,冠状动脉病变严重程度以积分计 ,以冠状动脉造影正常作对照并进行 t检验和多因素 L ogistic回归分析。结果　冠状动脉病变组男女 Hcy水平均显著高于对照组 (P<0 .0 1) ;病变组女性 TC、TG高于对照组 (P<0 .0 5 ) ,男性 HDL低于对照组 (P<0 .0 5 )。冠状动脉单支病变 Hcy已显著增高 (P>0 .0 5 ) ;诊断类型中 AMI>AP>OMI>其他 ,提示 Hcy是冠状动脉早期病变及冠状动脉病变活动的预报因子。从单因素相关分析看 ,Hcy与冠状动脉病变严重程度积分 (P<0 .0 1)、年龄、性别 (P<0 .0 5 )呈正相关关系。将 Hcy、TC、TG、HDL、L DL、年龄、性别、吸烟史等 8个冠状动脉病变易患因素引入 L ogistic回归模型进行分析 ,Hcy和年龄、性别是具有统计学意义的冠状动脉病变危险因素。结论　 1Hcy与冠状动脉病变的发生、发展可能有直接关系。 2 Hcy同年龄、性别一样是冠状动脉病变的一个独立危险因素

Relationship between plasma homocysteine and coronary disease diagnostic classification

Objective To investigate the relationship of plasma homocysteine (Hcy) and serum lipid with severity and classification of coronary lesions.Method Plasm Hcy and lipid level were measured in 88 patients who had received coronary angiography (CAG).The score for severity of coronary atherosclerotic lesions was assessed and patients with normal CAG were used as control group.The data were analyzed with t test and logistic regression.Results The patients with coronary lesions had a significantly higher Hcy level compared with control (P<0.05).The female patients with coronary lesions had a higher level of TCH and TG (P<0.05), while male patients had a lower level of HDL than control (P<0.05). Hcy was elevated significantly even in coronary lesions of single branch.Hcy was also associated with diagnostic classifications,which was higher in diseases with active lesions (AMI>AP>OMI>Other).It suggests Hcy is a predictor for preliminary or active coronary lesions.Hcy positively correlated with coronary lesion score (P<0.01),age,sex,(P<0.05).Hcy was apparently elevated in male elderly with high and serious coronary lesion.The author imported 8 risk factors of coronary diseases (Hcy,T CH,HDL,LDL,TG,age,sex,smoking) into logistic regression model.The study found Hcy,age,sex,are of coronary lesion risk factors with statistical significance.Conclusion ①Hcy is directly related to the initiation and development of coronary lesions.②Hcy is an independent risk factor for coronary lesions.