血清同型半胱氨酸和三酰甘油检测在老年冠心病病人预后中的意义分析

Significance of serum homocysteine and triglyceride levels in the prognosis of elderly patients with coronary heart disease

目的探讨冠心病老年病人冠状动脉造影Gensini评分、收缩压(SBP)和舒张压(DBP)与其体内血清同型半胱氨酸(Hcy)水平和三酰甘油(TG)水平相关性。方法选择150例冠心病老年病人作为研究对象,所有病人都经过冠状动脉造影确诊,计算Gensini评分、记录SBP值、DBP值,采用酶联免疫法(ELISA)检测血清中Hcy水平,与此同时检测TG水平,并就血清Hcy、TG水平和Gensini评分、血压之间的关系做分析,随访时做好血管狭窄和病情进展情况的记录,以此分析病情进一步发展及与入院时Hcy水平的相关性。结果 Logistics回归分析数据显示,血清Hcy水平可能是Gensini评分的独立影响因素(Hcy的β值=3.118,S.E=0.561,Waldχ2值=30.925,P=0.001,95%CI=7.532~67.838,P<0.05),Gensini评分与性别、体质量指数(BMI)、SBP、DBP、TG水平没有明显的相关性(P>0.05),对病情发展做进一步分层分析显示,Gensini评分进展病人与未明显进展病人相比有明显的入院时高Hcy水平,这种类似的结局同样出现在病情进展(心绞痛发作次数≥3次/天)病人中(P<0.05)。结论老年冠心病病人的早期预测冠心病进展和预后的重要物理学指标可能是血清Hcy水平,但是量化标准有待进一步证实。

Objective To explore the correlation of Gensini score,systolic blood pressure （SBP） ,diastolic blood pressure （DBP） ,ser-um homocysteine （Hey） level and triglyceride （TG） level in the coronary heart disease of elderly patients with coronary angiography. Methods 150 elderly patients with coronary heart disease as the research object,all patients undergone coronary angiography,Gensini score, SBP,DBP were recorded. Enzyme：linked immunosorbent assay （ELISA） was uesd to detect the serum Hey and TG,and the re-lationship between Gensini score,serum Hey,TG,and blood pressure were analyzed,Follow up was performed to record the vascular ste-nosis and the progression of the disease, in order to analyze the further development of the disease and the correlation with the level of Hey. Results The results of Logistics regression showed that the serum Hey level may be independent risk factors of Gensini score （Hey = 3. 118 , S . E = 0. 561, Wald X2 value = 30. 925 value, P= 0. 001 ,95% Cl = 7. 532-67. 838 ,P 〈 0.05 ） , no obvious relationship between Gensini score and gender, body mass index （BMI） , SBP, DBP and TG（P 〉0. 05） , further stratified analysis showed on the disease progression, Gensini score in obvious progress patients compared to no obvious progress patients with significantly higher Hey levels at admission, similar outcome also now the progress of the disease （ angina attack ≥3 times/day） patients （ P〈0.05 ） . Conclusion Serum Hey level may be an important predictor of the progression and prognosis of coronary heart disease in elderly pa-tients with coronary heart disease.