急性心肌梗死患者早期干预血清Hcy水平的变化及意义

Significance and change of serum homocysteine level in patients with acute myocardial infarction during the process of early intervention

目的 观察急性心肌梗死患者早期干预过程中血清同型半胱氨酸（Hcy）水平动态变化的临床意义。方法采用循环酶法检测2013年2月-2015年2月我院20例AMI患者（AMI组）及20例健康体检者（对照组）的血清Hcy水平。AMI组患者均早期采用尿激酶溶栓治疗,并动态检测溶栓前、后6 h及24 h血清Hcy水平的变化。结果血清Hcy水平：AMI组溶栓前[（28.46±5.24）μmol/L]、溶栓后6 h[（22.48±5.18）μmol/L]、溶栓后24 h[（15.69±4.35）μmol/L]、与对照组[（10.32±3.56）μmol/L]比较,差异有统计学意义（P〈0.01）;AMI组溶栓后6 h及24 h与溶栓前比较,差异有统计学意义（P〈0.01）;AMI组溶栓后24 h与6 h比较,差异有统计学意义（P〈0.01）。结论 Hcy可能参与了AMI心肌损伤过程,动态检测血清Hcy水平有助于判断AMI患者早期干预疗效。

Objective To observe the clinical significance of dynamic change of the serum homocysteine level in patients with acute myocardial infarction during the process of early intervention. Methods The serum level of homocysteine was detected in 20 patients with acute myocardial infarction（AMI group） and 20 cases of physical examination（control group） by circulating enzymatic method from February 2013 to February 2015 in our hospital. AMI group of patients were early thrombolysised with urokinase. The change of serum level of homocysteine was dynamicly detected before thrombolysis and at 6 h and 24 h after thrombolysis. Results The level of serum homocysteine of AMI group was（28.46±5.24）μmol/L before thrombolysis,（22.48±5.18）μmol/L at 6 h after thrombolysis, and（15.69 ±4.35）μmol/L at 24 h after thrombolysis. The level of serum homocysteine of the control group was（10.32±3.56） μmol/L. Compared with the control group,the difference was statistically significant in AMI group（P〈0.01）. Compared with before thrombolysis,the difference was statistically significant at 6 h and 24 h after thrombolysis（P〈0.01）. Compared with at 6 h after thrombolysis,the difference was statistically significant at 24 h after thrombolysis（P〈0.01）. Conclusion Homocysteine may be involved in the process of myocardial injury. Dynamic detection of serum homocysteine level is helpful to judge the effect of early intervention in patients with AMI.