血浆同型半胱氨酸水平与冠状动脉病变关系的临床研究

The Clinical Study of Relationship Between Plasma Homocysteine and Severity of Coronary Artery Lesion

目的探讨血浆同型半胱氨酸(HCY)水平与冠状动脉病变的相关性。方法选择临床拟诊冠心病病例132例,根据造影结果分为4组,即:A组,冠脉造影除外冠心病(无狭窄或狭窄<50%)(25例);B组,单支病变(35例);C组,双支病变(35例);D组,三支病变(37例)。冠脉造影前取静脉血及插管时取动脉血,采用免疫竞争法测定同型半胱氨酸水平。结果冠脉造影证实冠心病者同型半胱氨酸水平高于非冠心病者。动脉血组同型半胱氨酸水平:单支病变组高于非冠心病组,差异有统计学意义(P<0.05);双支病变组高于单支病变组,差异有统计学意义(P<0.05);三支病变组高于双支病变组,差异无统计学意义(P>0.05)。静脉血组同型半胱氨酸水平:单支病变组高于非冠心病组,差异有统计学意义(P<0.05);双支病变组高于单支病变组。差异有统计学意义(P<0.05);三支病变组高于双支病变组,差异无统计学意义(P>0.05)。结论高同型半胱氨酸水平与冠状动脉病变相关,静脉血同型半胱氨酸可替代动脉血同型半胱氨酸作为诊断冠心病及复杂程度的指标之一。

Objective To investigate the relationship between plasma homocysteine and severity of coronary artery lesion. Methotis 132 patients diagnosed clinically coronary heart disease （CHD） were selected and divided into four groups according to the outcome of coronary arteriography ： group A, including 25 patients without CHD （ no lesion or the severity of lesion within 50% in coronary arteries） , group B, 35 patients with single branch lesion, group C, 35 patients with double branch lesion, group D, 37 patients with three branch lesion. We collected venous blood and artery blood before coronary arteriography and measured plasma homocysteine. Re- sults There is higher plasma homocysteine level in patients with CHD than patients without CHD （ P 〈 0.05）. The level of plasma homocysteine is higher in patients with single branch lesion than without CHD （ P 〈 0. 05 ）. The level of plasma homocysteine is higher in patients with double branch lesion than with single branch lesion （P 〈 0. 05） ; The level of plasma homocysteine is higher in patients with three branch lesion than with double branch lesion （P 〉 0. 05）. It happens within not only venous blood group but also artery blood group. Conclusions The level of plasma homocysteine is correlated with severity of CHD. The level plasma homocysteine of venous blood can replace artery blood to diagnose CHD and evaluate severity of it.