同型半胱氨酸预测急性心肌梗死冠脉病变的研究

Homocysteine in predicting the severity of coronary artery in patients with acute myocardial infarction

目的:探索血同型半胱氨酸浓度与急性心肌梗死(AMI)患者冠脉病变严重程度的关系。方法:选取符合纳入及排除标准的AMI患者共118例。根据冠脉病变支数分为单支病变组(n=17)、双支病变组(n=25)和三支病变组(n=76);同时将这118例患者进行冠脉Gensini评分,并依据四分位数分为组1(n=29),组2(n=31),组3(n=29),组4(n=29)。分别比较年龄、性别、既往吸烟史、饮酒史、高血压史、糖尿病史、家族冠心病史;入院24 h内血总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、超氧化物歧化酶、同型半胱氨酸、随机血糖、N端-B型前脑钠肽及入院72 h内左室射血分数。结果:性别、同型半胱氨酸、随机血糖为冠脉病变支数的危险因素(P<0.05);同型半胱氨酸及左室射血分数为Gensini评分的危险因素(P<0.05)。结论:血同型半胱氨酸水平是预测AMI患者冠脉病变严重程度的重要标记物。

Objective:To explore the relationship between homocysteine(Hcy)and the severity of coronary artery in patients with acute myocardial infarction(AMI).Methods:A total of 118 patients with acute myocardial infarction who met the inclusion and exclusion criteria of AMI were selected.Groups according to the numbers of coronary artery lesion:single vessel lesion group(n=17);double vessels lesion group(n=25);three vessels lesion group(n=76);Groups according to the quartile of Gensinis scores:group 1(n=29),group 2(n=31),group 3(n=29),group 4(n=29).Compare the differences of age,gender,history of hypertension,diabetes,smoking,drinking,and family history of coronary heart disease;the results of total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,superoxide dismutase,Hcy,random blood glucose,N-terminal B-type probrain natriuretic peptide within 24 hours after admission and left ventricular ejectin fraction within 72 hours.Results:Gender,Homocysteine and random blood glucose are risk factors for the numbers of coronary artery lesions(P<0.05);The Homocysteine,left ventricular ejection fraction are risk factors for Gensinis scores(P<0.05);Conclusion:Homocysteine is an important marker for the severity of coronary artery in patients with AMI.