冠心病患者血浆同型半胱氨酸水平与血清叶酸、维生素B12浓度的相关性研究

目的观察高同型半胱氨酸血症（HHCY）是否是人群发生冠心病（CHD）的独立危险因素，同时探讨CHD患者血中同型半胱氨酸（HCY）、叶酸、VitB12浓度的变化及其相关性。方法选择CHD患者123例，正常对照101例。采用荧光偏振免疫分析法测定血浆HCY水平，化学发光免疫分析法测定血清叶酸、VitB12浓度。结果（1）CHD组患者血浆HCY平均浓度（15．04±7．58）μmol／L显著高于正常对照组（10．08±3．11）μmol／L，P〈0．01，CHD组患者血清叶酸平均浓度（4．02±2．27）ng/ml显著低于对照组（5．93±2．76）ng／ml，P〈0．01，CHD组患者血清VitBt2平均浓度（303．63±130．51）pg／ml与正常对照组（292．17±94．05）pg/ml比较差异无显著性（P〉0．05）。CHD组HHCY的发生率（36．59％）亦明显高于对照组（9．90％，P〈0．01）。CHD病因的多元Logistic回归分析显示HCY是CHD发病的独立危险因素。HCY对于CHD的相对危险度（RR）为1．238。相关分析显示：CHD组血浆HCY水平与血清叶酸、与VitB12浓度呈显著负相关（P=0．000）。结论HHCY是CHD的独立危险因素。CHD组血浆HCY水平与血清叶酸、与VitB12浓度呈线性负相关。血浆HCY、叶酸浓度检测有助CHD的诊断。

Correlative study on plasma homocysteine and serum folic acid, vitamin B12 in coronary heart disease

Objective To investigate if hyperhomocysteinemia is an independent risk factor associated with coronary heart disease(CHD) and to explore relationship between the levels of plasma homocysteine(Hcy) and serum folic acid,vitamin B12,and their changes in patients with CHD.Methods Plasma Hcy concentrations were measured by fluorescence polarization immunoassays(FPIA),and serum folic acid and vitamin B12 concentrations were measured by chemiluminescent immunoassay(CLIA) respectively in 123 patients with CHD and 101 normal control subjects.Results Plasma Hcy concentrations of patients with CHD were higher than that in controls(P<0.01),and serum folic acid concentrations were lower than that in normal controls(P<0.01).There were no significant difference between two groups(P<0.05) in Serum vitamin B12 concentrations.Logistic-regression analysis indicated that Hcy was an independent risk factor for CHD. The relative risk of hyperhomocysteinemia for CHD was 1.238(95% confidence interval,1.109 to 1.381,P=0.000).The frequency of the hyperhomocysteinemia in CHD cases was 36.59%,which was significantly higher than that in control subjects(9.90%,P<0.01).Negative correlation was found between Hcy and folic acid,vitamin B12(P=0.000) in CHD groups.Conclusion Hyperhomocysteinemia is an independent risk factor for CHD.There were negative correlation between the levels of Hcy and serum folic acid,vitamin B12.Determination of serum folic acid and vitamin B12 can provide evidence for diagnosis of CHD.