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 elder with coronary heart disease

目的研究老年冠心病患者高同型半胱氨酸血症（HHcy）的界定值.方法：对412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和低危组.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23.19μmol/L,其敏感性77.3%,特异性69.7%.高危组患者确诊冠心病269例,低危组患者确诊冠心病41例,两组冠心病发病率有统计学差异（91.2% vs 35.7%P 〈0.001）.高危组平均冠状动脉Gensini积分为33.43±4.22,低危组为9.51±2.89,有统计学差异 （P 〈0.01）.结论：老年冠心病患者高同型半胱氨酸血症（HHcy）的界定值为23.19μmol/L.

Objective Study the cutoff point of hyperhomocysteinemina （HHcy） in elder with coronary heart disease （CHD）. Methods The homocysteine （ Hcy） was measuredin 427 elderly patients who were suspected as having CHD. The cutoff point of HHcy was determined by receiver operator characteristic curve. According to the cutoff point, allpatients were divided into high-risk group and low-risk group. Cornary angiograghy （CAG） was performed in all patients and the number of coronary Gensini＇s score was used forevaluate the severity of atherosclerosis in patients diagnosed as CHD.Results The best cutoff point of HHcy was 23.19μmol/L and its sensitivity was 77.3% and 69.7%, respectively.269 patients were diagnosed as CHD in high-risk group, significantly higher than that in low -risk group（41 patients, 91.2% vs 35.7% P 〈0.001）. The average number of coronaryGensini＇s score of high-risk group higher than low -risk group （33.43±4.22 vs 9.51±2.89 P 〈0.01）. Conclusion The cutoff point of HHcy in elder with CHD was 23.19μmol/L.