血浆同型半胱氨酸与冠心病的相关性及其与冠心病传统危险因素的关系

Study on Correlation between HCY and Coronary Heart Disease and Traditional Risk Factors of Coronary Heart Disease

目的:探讨血浆同型半胱氨酸(Hcy)与冠心病相关性及与冠心病传统危险因素的关系研究。方法:120例行冠状动脉造影的患者,根据冠状动脉造影结果分为冠心病组(至少1支冠状动脉狭窄≥50%,n=70)及对照组(冠状动脉造影正常,n=50),测定两组血浆Hcy水平、血脂、射血分数等,以Gensini评分评价冠状动脉病变程度,应用Pearson单因素分析Hcy与冠心病患者血脂、心功能及冠状动脉病变程度的关系,应用Logistic多因素分析冠心病发生的危险因素。结果:冠心病患者体质量指数(BMI)、吸烟比例、高血压比例、血浆Hcy、低密度脂蛋白(LDL-C)均高于对照组(P<0.05),高密度脂蛋白(HDL-C)水平和左心室射血分数(LVEF)低于对照组(P<0.05);经Pearson单因素分析Hcy与冠脉病变Gensini评分和LDL-C呈正相关,与HDL-C、LVEF呈负相关(P<0.05);经Logistic多因素分析显示,高血压史、Hcy以及LDL-C是影响冠心病的独立危险因素,而HDL-C则是冠心病的保护因素。结论:Hcy与冠状动脉病变程度呈正相关,Hcy与高血压史及LDL-C水平都是冠心病的独立危险因素。

Objective：To investigate correlation between homocysteine（ HCY）and coronary heart disease and traditional risk factors of coronary heart disease. Methods：120 cases of patients with rou-tine coronary angiography,coronary heart disease by coronary angiography were divided into coronary heart disease group（ at least one coronary artery stenosis ≥50%,n=70 ）and control group（ normal coronary arteries,n =50 ）;testing plasma HCY levels,blood lipids,heart function level of both groups,evaluating severity of coronary artery disease by Gensini,applying of Pearson univariate analy-sis to analyze the relationship between HCY and coronary heart disease blood lipids,cardiac function and severity of coronary artery disease,applying Logistic multivariate analysis of risk factors for coro-nary heart disease. Results：Coronary heart disease patients′body weight（ BMI）,the proportion of smoking history,history of hypertension,plasma HCY,low-density lipoprotein（ LDL-C）were higher than control group（ P〈0 . 05 ）,high density lipoprotein（ HDL-C ）,proportion of left ventricular ejec-tion fraction（LVEF）were lower than control group（P 〈0. 05）. Single factor analysis by pearson showed that Hcy were positively correlated with coronary pathological Gensini score and LDL-C and negatively correlated with HDL-C and LVEF. After Logistic multivariate analysis,history of hyperten-sion,HCY,HDL-C level was an independent risk factor for coronary heart disease,while HDL-C is the independent risk factor to influence coronary disease. Conclusion：history of hypertension,HCY, LDL-C in patients with coronary heart disease and severity of coronary artery disease are closely related are independent risk factors for coronary heart disease.