老年冠心病患者血浆同型半胱氨酸和C-反应蛋白水平的变化及临床意义

Changes of homocysteic acid and C-reactive protein levels in blood plasma of elderly patients with coronary heart disease and their clinical significances

目的:探讨老年冠心病患者血浆同型半胱氨酸(Hcy)和C-反应蛋白(CRP)水平变化,阐明老年冠心病患者发病的危险因素。方法:将90例老年冠心病患者分为稳定型心绞痛(SAP)组30例、不稳定型心绞痛(UAP)组30例及急性心肌梗死(AMI)组30例。同时选择60岁以上体检健康的老年人30例为对照组。所有研究对象空腹采血后分离血浆,检测血浆Hcy和CRP。结果:老年冠心病各组TC和TG均高于对照组(P<0.05),TG升高呈AMI组>UAP组>SAP组趋势。老年冠心病各组血浆Hcy和CRP水平均高于对照组(P<0.05),老年冠心病各组之间血浆Hcy和CRP水平比较差异仍有显著性(P<0.05),呈AMI组>UAP组>SAP组趋势。结论:老年冠心病与Hcy和CRP水平升高有关,高同型半胱氨基(HHcy)血症和CRP水平升高可能是老年冠心病发病的一个危险因素。同时,血脂异常与HHcy血症和CRP水平升高有关联。随着老年冠心病严重程度的增加,血浆Hcy和CRP水平也增高,可以通过监测血浆Hcy和CRP水平增高程度来预测老年冠心病病变的严重程度。

Objective To investigate the changes of homocysteic acid （Hcy） and C-reactive protein （CRP） levels in blood plasma of elderly patients with coronary heart disease and elucidate the risk factors of elderly patients with coronary heart disease.Methods 90 elderly patients with coronary heart disease were divided into 3 groups：stable angina pectoris group （SAP）（n=30）,unstable angina pectoris group（UAP）（n=30）,acute myocardial infarction group（AMI）（n=30）.30 healthy elderly persons elder than 60 years old were enrolled as control group.Venous blood of all persons was harvested during empty stomach and plasma was separated.Then plasma Hcy and CRP were determined.Results The TC and TG levels in the three elderly coronary heart disease groups were significantly higher than those in control group （P〈0.05）. Especially the TG level increased following with the increase of severe degree of elderly coronary heart disease.The Hcy and CRP levels in the three elderly coronary heart disease groups were significantly higher than those in control group （P〈0.05）.There were significant differences of plasm Hcy and CRP levels between three elderly coronary heart disease groups（P〈0.05）.The plasma Hcy and CRP levels increased following with the increase of severe degree of elderly coronary heart disease.Conclusion Elderly coronary heart disease is related to Hcy emia and the increase of CRP level.This demonstrates that Hcy emia and the increase of CRP level may be risk factors for elderly coronary heart disease.At the same time,the abnormality of blood fat is related to Hcy emia and the increase of CRP level.Following with the increase of severe degree of elderly coronary heart disease,the plasm Hcy and CRP levels increase,too.So severe degree of elderly coronary heart disease can be predicted through determination of plasm Hcy and CRP levels.