不稳定型心绞痛患者血清同型半胱氨酸水平与红细胞及血小板参数的关系

Relevance of serum homocysteine level to erythrocyte and platelet parameters in patients with unstable angina pectoris

目的探讨不稳定型心绞痛(unstable angina pectoris,UAP)患者血清同型半胱氨酸(homocysteine,Hcy)水平与红细胞及血小板参数的关系。方法以2012年8月1日—2015年12月31日在铜陵市立医院心内科住院的60例UAP患者为研究对象,采用循环酶法检测血清Hcy,仪器法检测红细胞参数[红细胞计数、血红蛋白浓度、平均红细胞体积、红细胞体积分布宽度变异系数(coefficient of variation of red blood cell volume distribution width,RDW-CV)]以及血小板参数(血小板计数、血小板体积分布宽度、平均血小板体积、大血小板比率)。根据血清Hcy水平将UAP患者分为UAP伴高同型半胱氨酸血症(hyperhomocystinemia,HHcy)组和UAP正常Hcy组。比较两组患者红细胞及血小板参数水平,并分析UAP患者血清Hcy与红细胞及血小板参数的相关性。结果两组患者红细胞计数、血红蛋白浓度、平均红细胞体积、血小板计数、血小板体积分布宽度、平均血小板体积、大血小板比率差异均无统计学意义(P>0.05),而UAP伴HHcy组RDW-CV(13.81%±1.13%)及其超过参考上限的比例(39.4%)均明显高于UAP正常Hcy组(13.06%±0.97%、14.8%),差异均有统计学意义(P<0.05)。UAP患者血清Hcy与RDW-CV呈正相关(r=0.380,P<0.01),而与其他红细胞参数及血小板参数均无相关性(P>0.05)。结论高水平Hcy影响UAP患者红细胞体积异质性,这可能是HHcy参与UAP发生、发展的作用机制之一。

Objective To explore the relevance of serum homocysteine（Hcy） level to erythrocyte and platelet parameters in patients with unstable angina pectoris（UAP）. Methods Sixty patients with UAP were collected in Tongling Municipal Hospital from August 1 st, 2012 to December 31 st, 2015. Serum Hcy was measured by enzymatic cycling method. Erythrocyte parameters, such as red blood cell count（RBC）, hemoglobin, mean corpuscular volume（MCV）, coefficient of variation of red blood cell volume distribution width（RDW-CV）, and platelet parameters, such as platelet count（PLT）, platelet distribution width（PDW）, mean platelet volume（MPV）, platelet large cell ratio（P-LCR）,were measured with blood cell counter. All patients were classified into UAP with hyperhomocystinemia（HHcy） group and UAP with normal Hcy group according to the level of Hcy. The data in two groups were analyzed and the relevance of serum Hcy level to erythrocyte and platelet parameters was evaluated. Results The differences in the levels of RBC,hemoglobin, MCV, PLT, PDW, MPV, P-LCR between the two groups were not statistically significant（P〉0.05）; while the levels of RDW-CV and the proportion of RDW-CV above the upper reference limit of patients in the UAP with HHcy group（13.81%±1.13%, 39.4%） were higher than those in the UAP with normal Hcy group（13.06%±0.97%, 4.8%）, and the differences between the two groups were statistically significant（P〈0.05）. Correlation analysis showed that serum Hcy level of patients with UAP was significantly correlated with RDW-CV（r=0.380, P〈0.01） and was not significantly correlated with other erythrocyte and platelet parameters（P〉0.05）. Conclusion The high level of Hcy affects red blood cell volume heterogeneity in patients with UAP, which may be one of the mechanisms of HHcy participating in the occurrence and development of UAP.