冠心病患者血浆同型半胱氨酸水平与颈动脉内膜中层厚度相关性研究

Relationship between homocysteine and carotid intima-media thickness in coronary heart disease

目的观察冠心病患者血浆同型半胱氨酸(homocysteinemia,Hcy)水平,探讨其与颈动脉内膜中层厚度(intima media thickness,IMT)的关系。方法从河南省人民医院冠心病住院患者中,依据其血浆Hcy水平选取患者180例,其中分为Hcy水平≤10μmol/L的H1组和Hcy水平>10μmol/L的H2组患者各90例,并选择同期来医院进行健康体检人群90例为对照组。利用彩色多普勒超声测定三组受试者颈动脉内膜中层厚度,并对三组受试者进行相关血生化指标及Hcy水平的检测。结果分别测得3组患者血浆Hcy水平与颈动脉IMT值总体差异均有统计学意义(P<0.05),其中H2组的Hcy水平(23.63±2.87μmol/L)与颈动脉IMT值(1.38±0.07mm)与对照组(7.39±0.38μmol/L;0.79±0.15mm)及H1组(8.14±0.58μmol/L;0.87±0.10)比较均显著升高,差异有统计学意义(P<0.05)。多元逐步回归分析显示血浆Hcy水平是颈动脉IMT厚度的影响因素(B=0.003,P<0.001)。结论血浆Hcy水平升高是冠心病患者颈动脉IMT增厚的影响因素。

Objective To investigate the relationship between the levels of homocysteine(Hcy） and carotid intima-media thickness(IMT） in coronary heart disease patients. Methods Totally 180 patients with coronary heart disease in our hospital were included. The patients were divided into H1 group(Hcy ≤ 10 μmol/L） and H2 group(Hcy 〉10 μmol/L） dependent on the level of plasma Hcy. Meanwhile,90 healthy people were included in the study as the control group. The clinical biochemical indicators and the values of IMT were detected in the three groups.Results Measured three groups of patients with plasma Hcy levels and carotid IMT values respectively,the overall differences were statistically significant(P〈0. 05）. Compared with the control group(7. 39 ± 0. 38μmol/L; 0. 79 ±0. 15 mm） and group H1(8. 14 ± 0. 58μmol/L; 0. 87 ± 0. 10）,the level of plasma Hcy and carotid IMT values in group H2(23. 63 ± 2. 87μmol/L; 1. 38 ± 0. 07 mm） were significantly increased(P〈0. 05）. Based on the log-transformed values of IMT as the dependent variable,multiple stepwise linear regression showed significant associations of Hcy levels variables with increased IMT(B = 0. 003,P〈0. 001）. Conclusion The increased IMT level was associated with the level of plasma Hcy in patients with coronary heart disease.