冠心病患者半胱氨酸蛋白酶抑制剂C及同型半胱氨酸水平与冠状动脉病变程度的关系

Association between levels of cystatin C,homocysteine and coronary lesions in patients with coronary heart disease

目的探讨冠心病患者半胱氨酸蛋白酶抑制剂C(Cys C)、同型半胱氨酸(Hcy)水平与冠状动脉病变程度的相关性。方法根据冠状动脉造影结果将研究对象分为冠心病组(268例)和非冠心病组(268例),统计冠心病组患者病变累及支数,并按冠状动脉狭窄程度计算Gensini积分。分别测定并比较两组血清Hcy、Cys C等生化指标结果,分析Cys C、Hcy水平与Gensini积分、病变支数的相关性。结果冠心病组Cys C、Hcy水平明显高于非冠心病组(P均<0.01);Cys C、Hcy水平与Gensini积分呈正相关(r分别为0.245,0.232,P均<0.01);多元逐步回归分析表明Cys C、Hcy对Gensini积分的影响有统计学意义(β=20.255,t=2.749,P<0.05;β=0.327,t=2.093,P<0.05);随着病变支数的增加,Cys C、Hcy水平与Gensini积分均增高(P<0.05)。结论Cys C和Hcy水平增高在一定程度上可以反映冠状动脉病变的严重程度,可为临床开展危险分层与治疗提供参考。

Objective To explore the association between cystatin C （CysC）, homocysteine （Hcy） and the degree of coronary lesion. Methods The participants were divided into two groups according to coronary arteriography, which included coronary heart disease （CHD） group （n =268） and normal control group （n =268）. All the statistical data about the number and degree of coronary lesion were collected to calculate the Gensini score. The concentrations of CysC, Hcy in serum of all the patients were measured to analyze the correlations between the level of CysC, Hcy and Gensini score, coronary artery lesions. Results The levels of CysC and Hcy of CHD group were significantly higher than those of the normal control group （ P 〈0.01 ）. There were generally positive correlations between the levels of CysC, Hcy and Gensini score（r = 0.245, 0.232; P 〈 0.01 ） according to the linear correlation analysis. Multivariate analysis showed that CysC and Hcy were significantly associated with Gensini score （β = 20.255, t = 2.749, P 〈 0.05 ;/3 = 0.327, t = 2. 093, P 〈 0.05）. The Cys-C, Hcy levels and Gensini scores were increased （P 〈 0.05） along with the increasing number of obstructive vessels. Conclusion Combined detections of Hcy and CysC may show certain predictive value for the degree of coronary artery lesion and provide reference for the risk stratification and clinical treatment.