血浆同型半胱氨酸水平在老年急性心肌梗死患者中的临床意义

The clinical significance of plasma homocysteine in aged patients with acute myocardial infarction

目的 研究老年急性心肌梗死 (AMI)患者与血浆同型半胱氨酸 (Hcy)及血脂水平的变化及其相关性。方法 运用高效液相色谱仪及氧化酶法和聚乙醇测定 3 8例AMI患者及 3 0例健康对照组血浆Hcy和血脂水平。结果 AMI患者血浆同型半胱氨酸 (Hcy)、胆固醇 (Tc)、三酰甘油 (Tg)、低密度脂蛋白 (LDL)分别为 ( 17.89± 2 .2 4) μmol/L、( 5.82± 1.0 1)mmol/L、( 2 .61± 1.82 )mmol/L ,( 3 .51± 0 .2 3 )mmol/L ,均显著高于健康对照组 ( 10 .80± 0 .99) μmol/L ,( 4 .89± 0 .57)mmol/L ,( 1.15± 0 .3 3 )mmol/L ,( 3 .12± 0 .2 8)mmol/L ,差异有显著性意义 (P均 <0 .0 1) ,而AMI患者高密度脂蛋白 (HDL)较健康对照组低 ,分别为( 1.2 6± 0 .14 )mmol/L和 ( 1.45± 0 .13 )mmol/L ,差异有显著性意义 (P <0 .0 1) ,且Hcy与Tc、Tg、LDL均呈正相关 ,相关系数分别为 0 .513 (P <0 .0 1)、0 .52 9(P <0 .0 1)、0 .645(P <0 .0 1) ,而与HDL呈负相关 ,相关系数为 -0 .562 (P <0 .0 1)。结论 老年AMI患者血浆Hcy及Tc、Tg、LDL水平较正常对照组均增高 ,而HDL降低 。

Objective To investigate the relationship between plasma homocysteine level and lipids in aged patients with acute myocardial infarction(AMI).Methods 38 aged patients with acute myocardial infarction,30 normal subjects were involved in the study.Their plasma homocysteine levels were measured using high performance liquid chromatography and their lipids were measured using oxidase technique.Results The mean plasma homocysteine levels and cholesterol(Tc),triglycerides(Tg),low density lipoprotein(LDL) of aged patients with acute myocardial infarction were (17.16±2.24)μmol/L,(5.82±1.01)mmol/L,(2.61±1.82)mmol/L,(3.51±0.23)mmol/L respectively.These indexes were significantly higher than those of the normal subjects that were (10.80±0.99)μmol/L, (4.89 ±0.57)mmol/L,(1.15±0.33)mmol/L,(3.12±0.28)μmmol/L respectively,but high density lipoprotein(LDL)was(1.26±0.14)mmol/L for aged patients with acute myocardial infarction,(1.45±0.13)mmol/L for normal subjects.Statistically,the mean plasma homocysteine levels and lipids between acute myocardial infarction and normal groups were all significantly different(P<0..01),plasma homocysteine levels were significantly positive correlated with Tc,Tg and LDL,r=0.513(P<0.01),r=0.529(P<0.01),r=0.645(P<0.01),but were negative correlated with HDL(r=-0.562,P<0.01).Conclusion Plasma homocysteine level and lipids all significantly changed in aged patients with acute myocardial infarction.