心脏X综合征患者同型半胱氨酸与血管内皮功能关系研究

Study on association of homocysteine with vascular endothelial function in patients with cardiac syndrome X

目的 研究心脏X综合征患者血浆同型半胱氨酸（Hcy）与肱动脉血流介导血管扩张功能（FMD）的关系.方法 选取2015年1月至2016年6月在粤北人民医院住院期间诊断为心脏X综合征患者30例（心脏X综合征组）,另选取与心脏X综合征患者同期住院的其他疾病患者30例（对照组）,采用高分辨率超声技术检测FMD,采用循环酶法检测血浆Hcy水平.结果 ①X综合征患者血浆同型半胱氨酸水平明显高于对照组[（13.4±6.25）μmol/L比（9.78±4.3）μmol/L,P＜0.05];②X综合征患者肱动脉血流介导的血管扩张功能明显低于对照组[（5.21±3.19）％比（10.99±4.06）％,P＜0.01];③直线相关分析显示,X综合征患者血浆同型半胱氨酸水平与肱动脉血流介导的血管扩张功能之间存在负相关（r=-0.782,P＜0.01）.结论 心脏X综合征患者血浆同型半胱氨酸水平明显升高,肱动脉血流介导的血管扩张功能（FMD）受损,且血浆同型半胱氨酸水平与FMD呈负相关,表明心脏X综合征患者血浆同型半胱氨酸可能损害肱动脉血流介导的血管扩张功能.

Objective To investigate the association of plasma homocysteine （Hcy） with brachial artery flow mediated dilatation（FMD ） in patients with cardiac syndrome X. Methods Thirty cardiac syndrome X patients admitted in our hospital between January 2015 and June 2016 served as cardiac syndrome X patients group and thirty other types of hospitalized patients in the same period served as a control group in this study. The brachial artery FMD was measured in the two groups with high-resolution ratio ultrasound and plasma homocysteine levels were assayed by enzymatic cycling method. Results The plasma homocysteine levels were significantly higher whereas the brachial artery FMD was significantly lower in cardiac syndrome X patients group than in control group [ （ 13.4±6.25）μmol/L vs （9.78±4.3） μmol/L, P〈0.05, （5.21±3.19）% vs （ 10.99±4.06）%, P〈0.01 ]. Linear correlation analysis showed that the plasma homocysteine levels were negatively correlated with the brachial artery FMD （r=-0.782, P〈0.01）. Conclusion The plasma homocysteine levels were significantly higher and the brachial artery FMD was significantly lower in cardiac syndrome X patients, and the plasma homocysteine levels were negatively correlated with the brachial artery FMD, suggesting that plasma homocysteine might impair brachial artery flow mediated dilatation.