血清同型半胱氨酸与冠脉病变严重程度相关性研究

The association research about the serum homocysteine level and the severity of coronary artery in coronary heart disease patients

目的比较冠脉病变患者血脂异常情况,探讨血清同型半胱氨酸与冠脉病变严重程度的相关性。方法231例冠脉造影检查的病例,用t检验比较冠脉异常组和对照组血脂情况;用单因素差分析比较不同程度冠脉异常患者血清同型半胱氨酸水平。通过多因素Logistic回归分析影响高同型半胱氨酸血症的主要影响因素。结果231例患者高密度脂蛋白平均为1.05 mmol/L,超出正常范围,而异常组低密度脂蛋白、脂蛋白均高于对照组,差异有统计学意义(P均<0.05)。两组血清同型半胱氨酸水平不同,异常组为(23.62±11.95)μmol/L,明显高于对照组(14.28±5.25)μmol/L(P=0.001)。血清同型半胱氨酸水平随冠脉病变支数增多呈增高趋势,多支组、单支组血清同型半胱氨酸水平,均高于对照组,差异均有统计学意义(P<0.05),多支组略高于单支组,但差异无统计学意义(P>0.05)。多因素分析表明,有糖尿病史、冠脉病变程度是高同型半胱氨酸血症的影响因素。结论冠脉异常患者低密度脂蛋白、脂蛋白有所升高,糖尿病、高同型半胱氨酸可能是冠脉病变的主要影响因素。血清同型半胱氨酸水平与冠脉病变程度有一定关系。

Objective：To observe the serum lipid and homocysteine level in coronary heart disease patients with var-ying degrees of coronary artery abnormalities,and further explore the relationship between serum homocysteine levels and coronary artery disease severity. Methods：In the study 231 examiners were selected as the case. The the serum lipid in the two groups were analyzed by t test,and the homocysteine level was analyzed among the different degree of coronary artery a-nomalies with one-way analysis of variance. Then the main influence factors were chosen by logistic regression analysis. Re-sults：The high-density lipoprotein of all the research object was 1. 05 mmol/ L,beyond the normal range. The low density lipoprotein and lipoprotein in the lesion group were both higher than those in the control group（P 〈 0. 05）. The homocys-teine level in the lesion group（23. 62 ± 11. 95）μmol/ L was higher than that in the control group（14. 28 ± 5. 25）μmol/ L. Serum homocysteine levels showed a trend of increase with the coronary artery lesion count. But the homocysteine level be-tween multiple group and single group had no statistical difference. Diabetes and coronary artery lesion severity were the main influencing factors of the hyperhomocysteinemia. Conclusion：The lipoprotein and low density lipoprotein increases in the patients with coronary artery anomaly. Diabetes and coronary artery lesion severity are the main reasons for coronary ar-tery lesion.