冠心病患者血清同型半胱氨酸检测水平的意义分析及研究

Analysis and research of significance by serum homocysteine detection in coronary heart disease patients

目的研究并探讨血清同型半胱氨酸(HCY)检测在冠心病患者中的临床意义。方法 80例冠心病患者作为观察组,根据患者的冠状动脉(冠脉)病变支数(单支病变组、多支病变组)、冠脉狭窄程度(中度狭窄组、重度狭窄组)以及心绞痛类型进行分组,并随机选取同期参加体检的50例体检正常者作为对照组,对其血清HCY水平进行测定,比较观察组与对照组的血清HCY水平,并比较不同冠脉病变支数、不同冠脉狭窄程度、不同类型心绞痛患者的血清HCY水平,观察HCY与冠脉病变程度的关系。结果观察组的血清HCY水平为(25.49±14.93)μmol/L,明显高于对照组的(6.75±3.18)μmol/L,差异具有统计学意义(P<0.05)。80例患者中包括34例冠脉单支病变、46例冠脉多支病变。不同冠脉病变支数患者的HCY比较,多支病变组HCY水平为(31.54±15.82)μmol/L,高于单支病变组的(18.96±10.23)μmol/L(P<0.05)。80例患者包括51例中度狭窄、29例重度狭窄。不同冠脉狭窄程度患者的HCY比较,重度狭窄组HCY水平为(33.12±18.53)μmol/L,高于中度狭窄组的(17.64±9.18)μmol/L(P<0.05)。80例患者包括31例稳定型心绞痛、49例不稳定型心绞痛。不同类型心绞痛患者的HCY比较,不稳定型心绞痛组HCY水平为(30.59±10.27)μmol/L,高于稳定型心绞痛组的(20.15±8.43)μmol/L(P<0.05)。冠脉病变程度和HCY水平密切相关,且呈正相关(P<0.05)。结论冠心病患者的血清HCY水平出现异常增高,血清HCY可能参与到冠心病的发生、发展过程中,可作为冠心病病情监测及预后评估的重要指标。

Objective To research and investigate clinical significance by serum homocysteine （HCY） detection in coronary heart disease patients. Methods A total of 80 patients with coronary heart disease as observation group were divided by lesion number of coronary artery （single lesion group, multiple lesions group）, coronary artery stenosis degree （moderate stenosis group, severe stenosis group）, and angina pectoris types. There were 50 healthy people in physical examination as control group. Detection of serum HCY level was made to compare between the observation group and control group. Serum HCY levels in groups with different lesion number of coronary artery, coronary artery stenosis degree and angina pectoris types were compared. Observation was made on relationship between HCY and coronary artery disease. Results The observation group had serum HCY level as （25.49 ±14.93） ktmol/L, which was obviously higher than （6.75 ± 3.18）μmol/L in the control group, and the difference had statistical significance （P〈0.05）. There were 34 cases with single coronary lesion and 46 cases with multiple coronary lesions among the 80 patients. Comparison of HCY in patients with different lesion number of coronary artery showed higher HCY level in the multiple lesions group as （31.54±15.82）μmol/L than （18.96 ±10.23） μmol/L in the single lesion group （P〈0.05）. There were 34 cases with moderate stenosis and 29 cases with severe stenosis among the 80 patients. Comparison of HCY in patients with different coronary artery stenosis degree showed higher HCY level in the severe stenosis group as （33.12 -＋ 18.53） ~tmol/L than （17.64 _＋ 9.18） ~tmol/L in the moderate stenosis group （P〈0.05）. There were 31 cases with stable angina pectoris and 49 cases with unstable angina pectoris among the 80 patients. Comparison of HCY in patients with different angina pectoris types showed higher HCY level in the unstable angina pectoris group as （30.59 ±10.27） μmol/L than （20.15 ±8.43） μmol/L in the stable angina pectoris group （P〈0.05）. Degree of coronary artery lesion was closely and positively correlated with HCY level （P〈0.05）. Conclusion Due to abnormal increase of serum HCY level in patients with coronary heart disease, serum HCY can anticipate in occurrence and development of coronary heart disease, and it can act as the important index in monitoring coronary heart disease and prognosis evaluation.