血浆同型半胱氨酸与冠状动脉病变的关系探讨

目的探讨冠心病患者血浆同型半胱氨酸(Hcy)与冠状动脉病变程度的关系。方法选择行冠状动脉造影确诊为冠心病患者178例为冠心病组,并根据病变支数分为1支病变亚组(48例),2支病变亚组(57例),≥3支病变亚组(73例)。选择同期行冠状动脉造影检查正常者48例为非冠心病组。检测并比较2组患者血浆Hcy水平、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL),并测定冠心病组冠状动脉狭窄程度,记录Gensini冠状动脉病变积分。结果冠心病组血浆Hcy水平、TC、TG均高于非冠心病组,HDL低于非冠心病组,差异均有统计学意义(P<0.05)。冠心病患者随着冠状动脉病变程度的加重,血浆Hcy水平和Gensini评分均逐渐增加,1支病变亚组<2支病变亚组<≥3支病变亚组,与非冠心病组比较差异均有统计学意义(P<0.05)。Hcy、TC、TG是冠心病的危险因子,而HDL是冠心病的保护因子(P<0.05)。结论高Hcy是冠心病独立危险因素,随着冠状动脉病变程度加重而升高,可通过检测Hcy水平评价冠状动脉病变程度。

Study on the relationship between plasma homocysteine and coronary artery lesions

Objective To investigate the correlation between plasma homocysteine in patients with coronary artery disease （ Hcy） associated with the severity of coronary artery lesion .Methods 178 patients with coronary angiography con-firmed coronary heart disease were enrolled as CHD group , and according to the number of diseased arteries , they were divid-ed into 1 vessel disease subgroup （48 cases）, 2-vessel disease subgroup （57 cases）, 3-vessel disease subgroup （73 cases）. The same period 48 cases of normal patients were selected non-CHD group.Levels of plasma Hcy, total cholesterol （TC）, three triacylglycerol （TG）, high density lipoprotein （HDL） were detected and compared between the 2 groups, and to deter-mine the extent of coronary artery stenosis , record the Gensini coronary artery score .Results The levels of plasma Hcy , TC, TG of coronary heart disease group were higher than that in non CHD group , HDL was lower than that in non CHD group , the differences were statistically significant （ P 〈0.05）.Coronary heart disease patients along with the severity of coronary artery disease , plasma Hcy level and Gensini score were increased , 1 vessel disease subgroup 〈2 vessel disease subgroup 〈3 ves-sel disease subgroup, and differences between former and non CHD group were statistically significant （ P 〈0.05）.Logistic regression analysis revealed that Hcy , TC, TG were risk factors of coronary artery lesions ,while HDL was protective factor of coronary artery lesions;the differences were statistically significant （ P 〈0.05）.Conclusion High Hcy is an independent risk factor of coronary heart disease , and increased with the severity of coronary artery lesions , according to detect Hcy level , the severity of coronary artery disease can be assessed .