摘要
目的探讨同型半胱氨酸(HCY)、胱抑素C(Cys-C)对冠心病心肌缺血程度的影响。方法对照组34例,冠心病组127例分为稳定型冠心病(SA)、不稳定型冠心病(UA)和急性心肌梗死(AMI);以心肌缺血总负荷(TIB)作为心肌缺血程度的指标,观察各组、各亚组中超敏C反应蛋白(hs-CRP)、HCY、Cys-C对TIB的影响,以及HCY、Cys-C和hs-CRP的相关性。结果冠心病组及其各亚组血清hs-CRP、HCY、Cys-C水平和TIB均高于对照组。在冠心病各亚组内,hs-CRP、HCY、Cys-C水平差异均有统计学意义,AMI亚组>UA亚组>SA亚组;TIB水平,AMI组与UA组差异无统计学意义,但均高于SA组,差异有统计学意义;无论是在对照组还是在冠心病组及其各亚组,hs-CRP、HCY、Cys-C均与TIB呈正相关,此外,HCY、Cys-C与Hs-CRP也呈正相关。结论 HCY、Cys-C水平升高可加重冠心病患者心肌缺血程度,其机制与炎性反应有关。
Objective To investigate effects of homocysteine （HCY） and cystatin-C （Cys-C） on the extent of cardiac ischemia in coronary heart disease patients. Methods Thirty-four subjects were recruited in the control group, included in coronary heart disease group were 127 cases,which were further divided into 3 subgroups, stable angina pectoris （SA）.subgroup, unstable angina pectoris （UA）subgroup and acute myocardial infarction （AMI） subgroup. Total ischemie burden （T/B） was taken as the index of the extent of cardiac isehemia. Results TIB and the serum levels of high sensitive C reactive protein （hs-CRP）, HCY, Cys-C were significantly or very significantly increased in the coronary heart disease group and its all subgroups, compared to those in the control group. The serum levels of hs-CRP, HCY, Cys-C varied significantly or very significantly among subgroups in the coronary heart disease group, levels in AMI subgroup were highest, those in SA subgroup were the smallest. There was no difference in TIB between UA subgroup and AMI subgroup, but TIB in either of the 2 subgroups was very significantly higher than in UA subgroup. In any group or subgroup, a significant or very significant pos- itive relationship was found between TIB and hs-CRP, or HCY, or Cys-C. In addition, a significant or very sig- nificant positive relationship between hs-CRP and HCY, or Cys-C. Conclusion The increase of the serum levels of HCY or Cys-C leads to deterioration of cardiac ischemia, relative to the inflammation mechanism.
