老年女性冠心病患者血清同型半胱氨酸水平的分析

Logistic regression model for the relationship between homocysteine and patients with coronary heart disease in old women

目的探讨老年女性血清高同型半胱氨酸血症(Homocysteine,Hcy)与冠脉造影确诊的冠心病之间的关系。方法回顾性分析400例老年女性,根据冠状动脉造影结果分为两组,冠心病组260例,非冠心病组即对照组140例,观察两组吸烟、高血压病、2型糖尿病、高脂血症、高尿酸血症及高同型半胱氨酸血症与冠心病发病的关系。再将老年女性冠心病组按血同型半胱氨酸浓度大于25μmol/L的标准诊断高同型半胱氨酸血症分为高Hcy组及Hcy正常组,观察冠心病组高Hcy与冠心病其他危险因素的关系。结果①老年女性冠心病组高同型半胱氨酸血症的比例(54.6%)高于对照组(38.6%),差异有统计学意义(P<0.05)。②高Hcy血症为老年女性冠心病发生的影响因素(OR=1.916,95%CI:1.223～3.853,Waldχ2=9.37),但对其他指标进行校正采用多因素Logisitic逐步回归进行危险因素筛选,高Hcy血症并不是老年女性冠心病发生的独立危险因素。③老年女性冠心病组高同型半胱氨酸血症与冠心病其他危险因素如高血压、高血脂、糖尿病、吸烟无明显关系。结论老年女性高同型半胱氨酸血症为冠心病发生危险因素,但不是独立危险因素,老年女性冠心病患者高同型半胱氨酸血症与冠心病其他危险因素无明显相关性。

Objective To evaluate the association between homocysteine （Hcy） and angiographic coronary artery disease （CAD） in old women. Methods A total of 400 old women patients receiving coronary angiography were retrospectively analyzed and were divided into two groups according to the results of coronary angiography, 260 in coronary heart disease group and 140 in control group. The smoking history, essential hypertension, type 2 diabetes mellitus, hyperuricemia, homocysteine were observed in two groups and were studied their relationship with coronary heart disease. Next, A total of 260 old women CAD patients were divided into two groups according to the Hcy level for observing the relation of Hcy and other risk factors of CAD. Results ① In old women, the Hcy percentage was significantly higher in CAD group （54. 6） than that in control group （38.6% P 〈 0. 05 ）. ②Hcy was significantly associated with the presence of CAD in old women （ OR = 1. 916, 95 % CI ： 1. 223 - 3. 853, Wald χ^2 = 9. 37 ） However, after adjusting for other factors, logistic regression analysis showed that the association was no longer significant. Hcy was not an independent risk factor of CAD in old women. ③The Hcy level in old women with coronary heart disease was not related to hypertension, smoking, diabetes and high cholestesterol level. Conclusion In old women, Hcy was associated with CAD, but it was not an independent risk factor for CAD.