血清同型半胱氨酸水平与冠心病相关性研究

Relationship between serum homocysteine and coronary heart disease

目的探究血清同型半胱氨酸(Hcy)与冠心病临床分型及冠状动脉病变程度的相关性。方法选取2017年3月就诊于该院心内科行冠状动脉造影术的冠心病患者363例,其中心绞痛患者237例,急性非ST段抬高型心肌梗死患者54例,急性ST段抬高型心肌梗死患者72例,分别测定并比较各组患者血清Hcy水平,统计分析Hcy与冠心病临床分型的关系及与冠状动脉病变程度的相关性。结果急性ST段抬高型心肌梗死患者Hcy水平[(13.06±8.10)μmol/L]明显高于急性非ST段抬高型心肌梗死[(10.52±4.96)μmol/L]及不稳定性心绞痛患者[(10.84±6.26)μmol/L],差异有统计学意义(P<0.05),但急性非ST段抬高型心肌梗死与不稳定性心绞痛患者Hcy水平差异无统计学意义(P>0.05)。冠心病患者Hcy水平随病变血管支数及病变部位数增加而呈上升趋势,r分别为0.138、0.211,P<0.05。结论 Hcy水平与冠心病类型、冠状动脉病变程度相关,可作为冠心病的预测及冠状动脉病变严重程度的评估指标之一。

Objective To investigate the correlation between serum homocysteine（Hcy） and classification of coro- nary heart disease and coronary artery stenosis degree. Methods A total of 363 patients with coronary angiography were enrolled in this study,including 237 cases of angina pectoris,54 cases of acute non-ST-segment elevation myocar- dial infarction and 72 cases of acute ST-elevation myocardial infarction. The levels of serum Hcy in each group were measured,and the relationship between Hcy and clinical classification of coronary heart disease and the degree of core nary artery lesion were analyzed statistically. Results The level of Hcy in patients with acute ST-segment elevation myocardial infarction[ （13.06± 8.10）μmol/L] was significantly higher than that in patients with acute non-ST-seg ment elevation myocardial infarction [（10.52±4.96）μmol/L] and unstable angina pectoris [（10.84±6.26）μmol/L], the difference was statistically significant （P〈0.05）,but there was no significant difference in Hcy level between acute non-ST-segment elevation myocardial infarction and unstable angina pectoris（P〉0.05）. The level of Hcy in patients with coronary heart disease increased with the increase of the number of lesion vessels and the number of lesions（r= 0. 138,0. 211,P〈0.05）. Conclusion Hcy level is associated with coronary heart disease type and degree of coronary artery disease, which can be used as one of the predictors of coronary heart disease and the severity of coronary artery disease.