高同型半胱氨酸血症与冠脉病变的关系

目的　了解血清同型半胱氨酸 (Hcy)水平与冠脉病变的关系。方法　用断面调查的方法收集经冠状动脉造影确诊的冠心病患者 10 2例、非冠心病患者 5 2例 ,用高效液相色谱测定血清Hcy水平。 结果　冠脉病变与男性、吸烟、糖尿病及血清Hcy升高明显相关 ;冠心病组患者Hcy水平 [(19 6 8± 10 0 5 ) μmol/L]明显高于非冠心病组[(11 33± 4 17) μmol/L],P <0 0 1。冠心病合并糖尿病组冠脉病变程度较对照组明显严重。多元Logistic回归分析证实Hcy和糖尿病的比势比 (OR)均大于 1,并有显著差异。用前进法观察偏回归系数证实这两个因素是冠脉病变的独立危险因素。结论　血清Hcy升高和罹患糖尿病是导致冠脉病变的重要而各自独立的危险因素。

Significance of serum homocysteine in patients with coronary heart diseases.

Objective　To investigate the rel ationship between serum homocysteine(Hcy)and atherosclerosis.Methods　　Serum Hcy levels of 102 cases with coronary he artdiseases(CHD) and 52 non-CHD subjects were measured using high performance l iquidchromatography(HPLC)with fluorescence detection.Results　In a logistic regressionanalysis,the extent of coronary atherosclerosis was correspondingly related withsex,smoking,diabetes and Hcy level.The mean serum Hcy level was significantly higher incoronary pati ents than in controls(P<0.01).The patients with both diabetes and highlev els of Hcy had more severe coronary atherosclerosis than in controls.By multivar iateanalysis, the elevated Hcy level and diabetes were two independent factors in coronaryatherosclerosis.Conclusion　Hcy level and diabetes were two independent risk fact ors inthe development of atherosclerosis.