冠心病血清同型半胱氨酸与血管内皮功能的关系研究

Relationship between the level of serum homocysteine and endothelial function in patients with coronary heart disease

目的探讨冠心病(CHD)患者血清同型半胱氨酸(Hcy)与血管内皮功能的关系以及相关机制。方法选取2003年9月至2004年11月河北医科大学第一医院209例住院接受冠状动脉造影检查的患者为研究对象。根据冠脉造影结果,将其分为CHD组和对照组,用全自动荧光偏振免疫分析法测定Hcy水平。应用B超对所有研究对象的肱动脉进行扫查,在静息和反应性充血时分别测定肱动脉内径并计算各自的内皮依赖性血管舒张率(FMD%)和非内皮依赖性血管舒张率(NTG%)。结果CHD组患者血清Hcy高于对照组,差异有统计学意义(P<0.05)。CHD组患者FMD%水平低于对照组,差异有统计学意义(P<0.05)。多元逐步回归分析显示血肌酐、甘油三酯以及年龄与Hcy呈正相关;包括Hcy在内的4项指标与FMD%独立相关。结论CHD患者血清Hcy水平高于非CHD患者,高同型半胱氨酸血症与血管内皮功能失调相关。

Objective To investigate the relationship between serum homocysteine （Hey） level and endothelial function in patients with coronary heart disease （CHD）. Methods A total of 209 patients having undertaken coronary angiography were enrolled in this study. The serum concentrations of homocysteine were investigated for all subjects using fluorescence polarization immunoassay. B mode ultrasound was used to scan brachial arteries for all subjects at rest and during reactive hyperemia, and then the rates of endothelium -dependent and independent flow -mediated vasodilatation （ FMD% and NTG% ） of the brachial artery were calculated. Results The values of Hey in the CHD group were higher than that in the control group （P 〈0. 05, respectively）. The values of FMD% were lower in the CHD group than that in the control group （P 〈 0. 05, respectively）, Multiple stepwise regression analysis showed that three parameters including TG, Cr and age were significantly independently associaed with the level of Hey and four parameters including Hey were independently associated with FMD%. Conclusion The values of Hey in patients with CHD are higher than that in patients without CHD. Hyperhomocysteinemia is related to endothelial dysfuntion.