血清同型半胱氨酸水平对冠心病严重程度及支架置入治疗预后的影响

Study on the influence of serum level of homocysteine on the severity of coronary artery disease and outcome of stent placement

目的探讨血清同型半胱氨酸水平对冠心病患者病情严重以及支架置入预后的影响。方法选取2011至2015年心内科收治的冠心病患者90例,根据同型半胱氨酸(Hcy)是否在10μmol/L以上进行分组,观察组48例为高Hcy,对照组42例为低Hcy,对比分析两组患者的一般资料、SYNTAX评分以及1年随访的复合终点事件。结果观察组患者年龄大于对照组(P<0.05),高血压、糖尿病、高脂血症以及外周动脉疾病患病率高于对照组(P<0.05),冠脉靶血管、支架置入数量增加(P<0.05),STNYAX评分高与对照组(P<0.05),病变支数3支比率高于对照组(P<0.05),心脑血管不良事件发生率以及非致命性心肌梗死、非致命性脑卒中发生率高于对照组高(P<0.05)。结论血清Hcy水平升高与冠心病冠脉病变严重程度有关,也是患者支架置入术后心脑血管不良事件发生的重要因素。

Objective To explore the influence of blood level of homocysteine on the severity of coronary artery disease and the prognosis of stent implantation in patients with coronary heart disease（ CHD）. Methods A total of 90 patients with coronary heart disease treated in the department of cardiology of this hospital during 2011 to 2015 were allocated in this study,they were divided into groups according to the level of homocysteine（ Hcy）（ over than 10 mu mol/L）,48 patients with high level of Hcy were listed in observation group and 42 cases with low level of Hcy were listed in control group,then the general information,SYNTAX scores and composite end point event during 1 year follow-up period were compared between patients of these 2 groups. Results In comparison with control group,the age of patients in observation group was higher（ P〈0. 05）,the incidence rates of hypertension,diabetes,hyperlipidemia and peripheral artery disease were increased（ P〈0. 05）. The amount of target vessels and the number of coronary stent implantation in patients of observation group were increased（ P〈0. 05）,with higher STNYAX scores（ P〈0. 05）,and an increased ratio of lesion in three branches（ P〈0. 05）,and the incidence of cardiovascular adverse eventsand the rate of non-fatal myocardial infarction and non-fatal stroke rate were increased（ P〈0. 05）. Conclusion The elevated serum level of Hcy is closely associated with the severity of lesions in coronary artery in patients with coronary heart disease（ CHD）,and it is also an important factor in patients with postoperative cardiovascular adverse events.