四川西北地区老年冠心病患者高同型半胱氨酸血症界定值研究

The Cutoff Point of Hyperhomocysteinemina in Elderly with Coronary Heart Disease in North-west Area of Sichuan

目的研究四川西北地区老年冠心病患者高同型半胱氨酸血症(HHcy)的界定值。方法对581例可疑冠心病的老年患者测定同型半胱氨酸(Hcy),使用ROC曲线确定患者群的Hcy水平截断点,根据该值将患者分为高危组(418例)和低危组(163例)。所有患者行冠脉造影以确诊有无冠心病,以Gensini积分评价冠状动脉病变程度。结果血清Hcy水平的最佳截断点取22.57μmol/L,其敏感性78.2%,特异性69.3%。高危组患者确诊冠心病382例,低危组患者确诊冠心病56例,两组冠心病发病率有统计学意义(91.4%vs 34.4%,P<0.001)。高危组冠状动脉Gensini积分为32.15分±4.62分,低危组为8.62分±3.11分(P<0.01)。结论四川西北地区老年冠心病患者高同型半胱氨酸血症的界定值为22.57μmol/L。

Objective To study the cutoff point of hyperhomocysteinemina (HHcy)in elderly with coronary heart disease (CHD) in north west area of Sichuan.Methods The homocysteine was measured in 581 elderly patients who were suspected patient with CHD.The cutoff point of HHcy was determined by receiver operator characteristic curve.According to the cutoff point,all patients were divided into high risk group and low risk group.Coronary angiography was performed in all patients and the number of coro-nary Gensini's score was used to evaluate the severity of atherosclerosis in patients diagnosed as CHD.Results The best cutoff point of HHcy was 22.57μmol/L and its sensitivity was 78.2% and specificity was 69.3%.There were 382 patients diagnosed as CHD in high risk group,they were significantly more than that in low risk group (56 patients,91.4% vs 34.4%,P<0.001).The average coronary Gensini’s score of high risk group was higher than low risk group (32.15±4.62 vs 8.62±3.11,P<0.01).Conclusion The cutoff point of HHcy in elderly with CHD in north west area of Sichuan was 22.57μmol/L.