血脂、血同型半胱氨酸水平与冠状动脉病变程度的相关性研究

Study on the Relationship between Blood Lipids,Homocysteine Levels and the Severity of Coronary Artery Lesions

目的探讨血脂、血同型半胱氨酸(Hcy)水平与冠状动脉病变严重程度之间的关系。方法选择2012年11月至2015年5月在我院心内科疑似冠心病(CHD)患者756例,经冠脉造影(CAG)检查被排除CHD患者389例,CHD患者367例,根据Gensini评分CHD患者被分为低危组173例(<20分)、中危组112例(20分~40分)、高危组82例(>40分),分析患者血脂与血Hcy水平。结果 CHD组血清低密度脂蛋白(LDL-C)(3.21±1.59)mmol/L与Hcy(16.35±5.49)μmol/L均高于对照组(2.51±1.06)mmol/L、(11.36±4.91)μmol/L(P<0.05);血清LDL-C与Hcy水平低危组(2.68±1.35)mmol/L、(12.56±5.35)μmol/L,中危组(3.29±1.42)mmol/L、(16.59±8.64)μmol/L,高危组(3.56±1.57)mmol/L、(18.34±9.56)μmol/L,组间比较差异均有统计学意义(P<0.01),血清LDL-C及Hcy与冠脉病变程度呈正相关(Spearman系数=0.689、0.664,P<0.05)。结论血清LDL-C及Hcy水平可作为反映冠脉病变严重程度的临床指标。

Objective To investigate the relationship between serum lipids,homocysteine（Hcy） levels and severity of coronary artery disease. Methods 756 patients with suspected coronary artery disease（ CHD）from November 2012 to May 2015in department of Cardiology in our hospital were selected, of which 389 cases of patients were excluded from CHD by examination of coronary angiography（CAG）,and 367 patients with CHD. According to the Gensini score, patients with CHD were divided into low risk group 173 cases（ 〈 20 points）, middle risk group 112 cases （20 to 40 points）, highrisk group 82 cases （ 〉 40 points）, and blood lipids and blood Hcy levels were analyzed. Results Serum low density lipoprotein （ LDL-C ） （ 3.21 ± 1.59 ） mmol/L and Hcy （16. 35 ±5.49）Ixmol/L in group CHD were both higher than those in control group （2. 51 ± 1.06 ）mmol/L, （11.36 ± 4. 91 ） μmol/L（P 〈 0. 05 ） ; The serum LDL-C and Hcy levels were （2. 68 ± 1.35 ） mmol/L, （ 12. 56 ± 5. 35 ） μmol/L in the low risk group, （ 3.29 ± 1.42 ） mmol/L, （ 16. 59 ± 8.64 ） p,mol/L in the middle risk group, and （ 3.56 ± 1.57 ） mmol/L, （ 18. 34 ± 9. 56 ） μmol/L in the high risk group, significant difference between groups（ P 〈 0. 01 ） ;And serum LDL-C and Hcy were positively related with the severity of coronary artery lesions （ Spearman coefficient = 0. 689,0. 664, P 〈 0. 05 ）. Conclusion Serum LDL-C and Hcy levels can be used as indicators of the severity of coronary artery disease.