血浆同型半胱氨酸、高密度脂蛋白胆固醇水平与Framingham十年冠心病发病风险的关系研究

Research of Association between Plasma Homocysteine,HDL-C and CHD Risk According to Framingham Score

目的:分析Framingham十年冠心病风险低危组、中危组、高危组患者及冠心病患者血浆同型半胱氨酸(homocysteine,Hcy)的水平变化,并探讨其与Framingham十年冠心病发病风险的关系。方法:搜集2011-3至2012-12于中山大学孙逸仙纪念医院心血管内科住院经冠状动脉造影诊断为冠心病的患者共239例,其中男性154例,女性85例。另外搜集同期健康体检者336例,分别对其进行Framingham风险评分后分为十年冠心病风险低危组、中危组、高危组。比较分析各组血脂指标及Hcy水平。结果:低危组Hcy水平低于高危组和冠心病组,中危组低于冠心病组(P<0.05);高危组、低危组和中危组高密度脂蛋白胆固醇水平(high den-sity lipoprotein cholesterol,HDL-C)均高于冠心病组(P<0.05);低危组Hcy/HDL-C低于中危组和冠心病组,高危组和中危组低于冠心病组(P<0.05)。Logistic回归分析表明HDL-C、nonHDL-C、Hcy/non HDL-C分别于冠心病的发生相关(β=-0.049,P=0.027;β=0.993,P<0.001;β=0.275,P=0.038)。结论:高Hcy、低HDL-C水平与Framing-ham十年冠心病发病风险及冠心病的发生密切相关。

Objective：To analyze the level of plasma homocysteine in patients with low risk,medium risk,highrisk of coronary heart disease according to Framingham score and coronary heart disease,and explore the association be-tween homocysteine and CHD risk. Methods：The 239 patients diagnosed with CHD via coronary arteriography in cardio-vascular department of Sun Yat-sen University Memorial Hospital from March 2011 to December 2012 including 154 males and 85 females and 336 healthy controls were collected. The patients were divided into low risk,medium risk,high risk group of coronary heart disease according to Framingham score. The lipid profile and Hcy level were analyzed.Results： Hcy in low risk group was lower than high risk and CHD group,and Hcy in medium risk group was lowerthan CHD group（P〈0.05）. HDL in high risk,medium risk,low risk group was higher than CHD group（P〈0.05）. Hcy/HDL-C in low risk group was lower than medium risk and CHD group,and in high risk,medium risk group was lowerthan CHD group（P〈0.05）. HDL-C,nonHDL-C and Hcy/nonHDL-C were individually correlated with CHD（β =-0.049,P=0.027;β=0.993,P〈0.001;β=0.275,P=0.038）. Conclusion：high Hcy and low HDL-C were associated withCHD risk according to Framingham score and CHD occurrence.