血清同型半胱氨酸和脂蛋白(a)检测对冠心病的诊断价值

Diagnostic Value of Detection of Serum Homocysteine and Lipoprotein(a)on Coronary Heart Disease

目的探讨血清同型半胱氨酸(Hcy)和脂蛋白(a)[Lp(a)]检测对冠心病(CHD)的诊断价值。方法选择86例高血脂冠心病患者为观察组,根据疾病类型分为稳定型心绞痛(SAP)28例,不稳定型心绞痛(UAP)32例和心肌梗死(AMI)26例,同时选择50例同期健康者为对照组。检测并比较3组患者血清Hcy和Lp(a)水平。结果观察组患者血清Hcy[(18.22±3.32)μmol·L^(-1)]和Lp(a)[(271.76±26.32)mg·L^(-1)]水平均高于对照组[(11.55±2.42)μmol·L^(-1),(165.47±11.21)mg·L^(-1)](P均<0.05);SAP、UPA、AMI组患者的血清Hcy水平分别为(12.26±2.50)μmol·L^(-1)、(17.58±3.72)μmol·L^(-1)、(24.73±4.28)μmol·L^(-1),Lp(a)水平分别为(216.43±23.72)mg·L^(-1)、(290.12±25.36)mg·L^(-1)、(331.15±26.57)mg·L^(-1),随着病变严重程度的增加,患者血清Hcy、Lp(a)水平呈逐渐升高的趋势(P均<0.05)。结论测定血清Hcy和Lp(a)水平对评估冠心病的病情严重程度及发病后的诊断、治疗与预后有重要意义。

Objective To explore the diagnostic value of serum homocysteine(Hcy)and lipoprotein(a)[Lp(a)]for coronary heart disease(CHD).Methods Totally 86 patients with hyperlipoidemia and clinically diagnosed coronary heart disease were selected to be the observation group.Among them,28 patients with stable angina pectoris(SAP),32 patients with unstable angina pectoris(UAP)and 26 patients with myocardial infarction(AMI).And 50 healthy controls were selected.The results of serum Hcy and Lp(a)were compared and analyzed.Results The levels of serum Hcy(18.22±3.32)μmol·L^(-1) and Lp(a)(271.76±26.32)mg·L^(-1) in the observation group were significantly higher than those of the control group Hcy(11.55±2.42)μmol·L^(-1) and Lp(a)(165.47±11.21)mg·L^(-1).There was a significant difference between the two groups(P<0.05).The serum Hcy levels of patients in SAP,UPA,and AMI groups were(12.26±2.50)μmol·L^(-1),(17.58±3.72)μmol·L^(-1),(24.73±4.28)μmol·L^(-1).The Lp(a)levels were(216.43±23.72)mg·L^(-1),(290.12±25.36)mg·L^(-1),(331.15±26.57)mg·L^(-1) respectively.The levels of serum Hcy and Lp(a)increased gradually with the increase of disease severity(P all<0.05).Conclusion The determination of serum homocystine and Lp(a)levels is of great significance for assessing the severity of coronary heart disease,as well as the diagnosis,treatment and prognosis after the onset.