广州人血同型半胱氨酸与心血管疾病的相关性分析

Correlation between homocysteine and cardiovascular diseases in Guangzhou patients

目的研究广州市红十字会医院心内科收治的广州患者血同型半胱氨酸(homocysteine,Hcy)与心血管疾病的关系。方法回顾性分析2014年4月至2015年3月期间的1 377例原发性高血压(高血压)和(或)冠状动脉粥样硬化性心脏病(冠心病)患者的临床资料,统计人群的平均血浆Hcy浓度,分析Hcy与冠心病、急性心肌梗死、心力衰竭、C反应蛋白浓度升高的关系。结果我院高血压人群平均血浆Hcy浓度为(14.26±7.40)μmol/L,高Hcy发生率为72.1%;冠心病人群平均血浆Hcy浓度为(14.51±6.95)μmol/L,高Hcy发生率为75.7%;急性心肌梗死人群平均血浆Hcy浓度为(15.49±7.73)μmol/L,高Hcy发生率为78.1%。其中A组(Hcy≥15 mmol/L)的冠心病、急性心肌梗死、心力衰竭、C反应蛋白浓度升高的发生率均较C组(Hcy<10 mmol/L)显著升高,差异有统计学意义(71.4%、13.9%、31.9%、60.9%vs.56.6%、8.4%、11.7%、41.6%,P均<0.05);B组(15mmol/L>Hcy≥10 mmol/L)冠心病、心力衰竭发生率较C组显著升高,差异有统计学意义(69.4%vs.56.6%、17.8%vs.11.7%,P均<0.05)。结论血浆Hcy浓度升高与心血管疾病相关Hcy浓度越高,冠心病、急性心肌梗死、心力衰竭、C反应蛋白浓度升高的发生率升高。

Objectives To investigate the correlation between homocysteine （Hcy） and cardiovascular diseases （CVD） in Guangzhou patients who admitted in Guangzhou Red Cross Hospital. Methods This 12-month retrospective study was conducted on 1 377 patients with hypertention or/and coronary heart disease （CHD） from April 2014 to March 2015. Average concentration of Hcy was measured. Relationship between concentration of Hcy and CHD, acute myocardial infarction （AMI）, heart failure （HF） and elevated C-reactive protein （CRP） was analyzed. Results The average concentrations of Hey were （14.26±7.40） μmol/L, （14.51±6.95）μmol/L, （15.49±7.73） μmol/L and the incidences of elevated Hcy were 72.1%, 75.7%, 78.1% in patients with hypertention, CHD and AMI, respectively. The frequencies of CHD, AMI, HF and elevated CRP were 71.4%, 13.9%, 31.9%, 60.9% in group A （Hcy≥ 15 mmol/L） versus 56.6%, 8.4%, 11.7%, 41.6% in group C （Hcy〈10 mmol/L）, respectively （P〈0.05）. In addition, the frequencies of CHD and HF were 69.4% and 17.8% in group B （ 15 mmol/L〉Hcy≥10 mmol/L）, which were significantly higher than those in group C （56.6% and 11.7%, P〈0.05）, respectively. Conclusions Elevated Hcy is correlated to the incidence of CVD. As serum Hcy concentration elevating, the frequencies of CHD, AMI, HF and elevated CRP are increasing.