同型半胱氨酸血症与冠心病患者冠脉病变稳定性及病变程度关系研究

目的探讨同型半胱氨酸血症(homocysteine,HCY)与冠心病患者冠状动脉病变稳定性及病变程度的关系.方法选择不稳定型心绞痛患者56例,稳定型心绞痛患者40例.20例冠状动脉造影正常者作为对照组.根据冠状动脉造影结果,分为单支、双支以及三支病变组,并根据冠状动脉狭窄程度及部位进行记分.采用酶联免疫吸附双抗夹心法测定血浆HCY水平.结果不稳定型心绞痛组HCY水平显著高于稳定型心绞痛组(P＜0.01),两组均明显高于对照组(P＜0.01).三支病变组HCY水平高于双支病变组,无显著性差异,显著高于单支病变组(P＜0.01);双支病变组高于单支病变组,无显著性差异;三组均显著高于正常对照组.HCY与冠状动脉狭窄积分正相关(r=0.517,P＜0.01).多元Logistic逐步回归分析表明HCY为不稳定型心绞痛及病变狭窄程度的独立危险因素.结论HCY与冠心病患者冠状动脉病变稳定性和狭窄程度独立相关,高HCY引起冠状动脉病变不稳定和病变程度加重.HCY可作为判定冠心病患者冠状动脉病变稳定性和狭窄程度的指标之一.

THE RELATIONSHIP BETWEEN HOMOCYSTEINE AND STABILITY OF LESIONS,SEVERITY OF CORONARY STENOSIS IN PATIENTS WITH CORONARY HEART DISEASE

ObjectiveTo investigate the relationship between homocysteine(HCY) and stability of coronary lesions,severity of coronary stenosis in patients with coronary heart disease.MethodsThe study group included 96 consecutive patients,and among them,56 patients were with unstable angina pectoris,40 patients with stable angina pectoris.At the same time 20 patients with normal angiography were used controls.According to the number of vessels involved in angiography,these patients were devided into triple-vessel,double-vessel and single-vessel lesions groups.Levels of HCY were measured with ELISA.ResultsThe levels of HCY were significantly higher in unstable angina pectoris group than those in stable angina pectoris group(P<(0.01)),and they were significantly higher than those in control group(P<(0.01));The levels of plasma HCY in patients with triple-vessel or doublevessel lesions were significantly higher than that with single-vessel lesions(P<(0.01)).There were positive relations between levels of HCY and score of coronary stenosis(r=(0.517),P<(0.01)).Multiple regression analysis of Logistic indicated that HCY was an independent risk for the stability of lesions and the severity of stenosis in patients with coronary heart disease.ConclusionHCY was independently related to the stability of lesions and severity of stenosis in coronary artery.HCY resulted in instability of lesions and development of severity.HCY might be one of the predictors of stability and severity in coronary lesions.