冠心病患者同型半胱氨酸水平测定及其临床意义

CLINICAL INVESTIGATION ON SERUM TOTAL HOMOCYSTEINE IN PATIENTS WITH CORONARY ARTHEROSCLEROTIC DISEASE

目的 :通过对冠状动脉造影患者血清总同型半胱氨酸水平测定 ,探讨其对冠心病的诊断价值。方法 :将6 0例冠脉造影患者分为冠心病组 (狭窄程度≥ 5 0 % ) 31例 ,与非冠心病组 (狭窄程度 <5 0 % ) 2 9例 ,其中冠心病组统计病变累及支数 ,并按冠脉狭窄程度分级得出冠脉狭窄程度记分 (CSS)。运用酶免分析法分别测定两组的血清总同型半胱氨酸 (t Hcy)浓度并进行比较。将 t Hcy水平与性别、年龄、收缩压、冠心病病变累及支数及冠脉狭窄程度记分 (CSS)等采用多元回归进行分析。结果 :冠心病组患者血清 t Hcy浓度 (17.8± 7.1μmol/ L)显著高于非冠心病组 (10 .0± 5 .8μm ol/ L )。多元回归分析表明 :非冠心病组 t Hcy增高与收缩压的相关性最强 ;冠心病组 t Hcy增高与病变累及支数及冠脉狭窄程度记分 (CSS)成正相关。结论 :高同型半胱氨酸血症是冠状动脉粥样硬化性心脏病的危险因子 。

Objective: To study the relationship between the levels of serum total homocysteine (tHcy) and severity of coronary artherosclerosis. Methods: 60 patients undergoing diagnostic coronary angiography were divided into two groups: 31patients (narrowing ≥50% in diameter) in CHD group and 29 patients (narrowing <50% in diameter) in non-CHD group. The number of artherosclerotic artery and the coronary stricture score ( CSS ) were recorded, then the serum tHcy levels were examined with the Homocysteine Enzyme Immunoassay.Results: Serum total homocysteine level was significantly higher in CHD group than in non-CHD (17.8±7.1μmol/L versus 10.0±5.8μmol/L,P<0.05 ). Statistically, tHcy showed great relationship to the levels of systolic blood pressure in non CHD group. There was a distinctly positive correlation of tHcy associated with the extent of coronary artherosclerosis in CHD group. Conclusion: Hyperhomocysteinemia was an risk factor for coronary artery disease. The extent of coronary artherosclerosis evaluated by an angiographic coronary score was correlated positively to serum total homocysteine levels (r=0.25,P< 0.05 ).