血清同型半胱氨酸及踝臂指数水平与冠心病病变程度的相关性研究

Correlation analysis of serum homocysteine,ankle-branchial index and the severity of coronary artery disease

目的观察冠心病(CHD)患者踝臂指数(ABI)、血清同型半胱氨酸(HCY)水平,探讨ABI和HCY与冠心病患者冠脉病变程度之间的相关性。方法选取拟诊CHD行冠状动脉造影术患者152例,根据冠脉造影结果分为冠心病组(114例)和非冠心病组(38例),根据病变程度又将冠心病组分为单支病变组、双支病变组和多支病变组,所有入组个体分别测定其ABI值,同时取患者空腹肘静脉血测定HCY。结果与非冠心病组相比,冠心病组血清HCY升高,差异有统计学意义(P<0.05),ABI值无差异(P>0.05);冠心病组中多支病变组、双支病变组的HCY值高于单支病变组,多支病变组的ABI值低于单支病变组,冠状动脉严重病变组的ABI值异常率和HCY异常率均高于非严重病变组,差异均具有统计学意义(P<0.05)。结论血清HCY升高和ABI值降低与冠心病的发病及冠脉病变程度有关,联合应用ABI及HCY对冠心病及冠脉病变严重程度的评估具有重要作用。

Objiecdve To observe the level of serum homocysteine （HCY） and ankle-branchial index （ABI） value of coronary heart disease （CHD）, to search for correlation between the extent of coronary lesions with ABI and HCY. Methods 152 patients who were suspected as CHD were collected, all petients were divided into CHD group and nonCHD group according to coronary arteriography results, the CHD group were further divided into one-vessel subgroup, two-vessel subgroup and multiple-vessel subgroup, all the patients were measured with ABI, and serum HCY level were detected in preprandial blood. Results Compared with the non-CHD group, the serum HCY increased in CHD group, and the difference was signifieant（P 〈 0.05）, but the ABI between two groups had no significant difference（P 〉 0.05）. In CHD group, the serum HCY level of multiple-vessel subgroup and two-vessel subgroup increased compare with one-vessel subgroup, the ABI of multiple-vessel subgroup decreased compare with one-vessel subgroup, the differences were significant （P 〈 0.05）. The abnormal rate of ABI and HCY in severe CHD group were higher than nonsevere group （P 〈 0.05）. Conclusion Serum HCY and ABI are associated with extent of coronary lesions, ABI combined with serum HCY could provide a imoortant way for evaluating the severity of coronary artery disease.