血浆Hcy水平与冠心病的关系

Relationship Between Plasma Homocysteine Levels and Severity of Coronary Heart Disease

目的探讨血浆同型半胱氨酸(Hcy)水平与冠心病(CHD)的关系。方法将109例CHD患者分为三组,无症状型CHD组26例,稳定型心绞痛组(SA)45例,心肌梗死组(MI)38例,对照组为40例健康体检者。以微粒子酶免分析法检测其空腹血浆Hcy水平。同时根据冠脉造影进一步将观察对象分为一支病变组(46例),二支病变组(25例)和多支病变组(38例)。结果CHD患者血浆Hcy水平显著高于对照组(P<0.01),MI组显著高于AS组(P<0.05),AS组高于无症状型CHD组(P<0.05);多支病变组Hcy水平显著高于双支病变组(P<0.01),双支病变组高于一支病变组(P<0.05)。结论CHD患者血浆Hcy水平明显增高,且与冠状动脉病变程度及冠脉病变支数呈正相关,是CHD的危险因素之一。

Objective To study the relationship between plasma homocysteine （Hcy） levels and severity of coronary heart disease （CHD）. Methods Plasma Hcy levels were determined with MELA in 109 patients with CHD and 40 controls. Clinicaly, the 109 patients were of 3 groups： （1） asymptomatic, n =26（2） stable angina, n =45 and （3） myocardial infarction, n = 38. The patients could also be classified into 3 groups according to the number of occluded vessels demonstrated in coronary arteriogram ： （1）single vessel, n = 46 （2） double, n = 25 and （3） multiple, n = 38. Results The plasma Hcy levels in CHD patients were significantly higher than those in controls （ P 〈 0.01 ）. Levels in the patients with myocardial infarction were significantly higher than those in patients with stable angina （P 〈 0.05 ）. Again, levels in patients with stable angina were significantly higher than those in asymptomatic patients （P 〈0.05）. Patients with multiple vessels occlusion had their Hcy levels significantly higher than those in patients with double vessels occlusion （P 〈 0.05 ）. Again, patients with double vessels occlusion had ttcy levels significantly higher than those in patients with only single vessels occluded （ P 〈 0.05 ）. Conclusion The plasma levels of Hcy were markedly elevated in CHD patients and were closely related to the severity of the disease process.