冠心病患者血清LP(a)、Hcy和HO-1水平与SYNTAX评分关系研究

Relationship Between Serum LP(a),Hcy and HO-1 levels and SYNTAX Score in Patients with Coronary Heart Disease

目的探讨血清脂蛋白(a)[LP(a)]、同型半胱氨酸(Hcy)、血红素加氧酶1(HO-1)水平与冠状动脉SYNTAX评分的关系。方法选取2022年7月-12月于简阳市人民医院就诊,并经冠状动脉造影确诊为冠状动脉粥样硬化性心脏病(CHD)患者386例作为研究对象,设为CHD组,根据SYNTAX评分分为低危组(≤22分,n=98)、中危组(23~32分,n=120)、高危组(≥33分,n=168),另选100例行冠状动脉造影结果提示未见明显狭窄的患者为对照组,采集空腹静脉血标本检测血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、LP(a)、Hcy和HO-1水平,比较上述指标在各组的差异,并采用Pearson相关分析上述指标与SYNTAX评分、冠状动脉狭窄程度积分、病变特点积分的相关性。结果CHD组血清LP(a)、Hcy水平高于对照组,HO-1水平低于对照组,差异有统计学意义(P<0.05);CHD组各亚组间血清LP(a)和Hcy水平依次为低危组<中危组<高危组(P<0.05),血清HO-1水平依次为低危组>中危组>高危组(P<0.05)。Pearson相关分析显示,CHD患者冠脉病变狭窄程度积分、病变特点积分、SYNTAX评分与血清LP(a)和Hcy水平呈正相关(P<0.05),与HO-1水平呈负相关(P<0.05)。结论CHD患者血清LP(a)和Hcy水平与SYNTAX评分呈正相关,HO-1水平与SYNTAX评分呈负相关,三项指标均可用于评估冠脉病变程度,对于CHD的预防和诊疗具有重要意义。

Objective To investigate the relationship between serum lipoprotein(a)[LP(a)],homocysteine(Hcy),heme oxygenase-1(HO-1)levels and coronary artery SYNTAX score.Methods A total of 386 patients with coronary atherosclerotic heart disease(CHD)diagnosed by coronary angiography in the People’s Hospital of Jianyang City from July to December 2022 were selected as the CHD group.According to the SYNTAX score,they were divided into low-risk group(≤22 scores,n=98),medium-risk group(23-32 scores,n=120)and high-risk group(≥33 scores,n=168).Another 100 patients with no obvious stenosis in coronary angiography were selected as the control group.Fasting venous blood samples were collected to detect serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),LP(a),Hcy and HO-1 levels.The differences of the above indicators in each group were compared,and Pearson correlation analysis was used to analyze the correlation between the above indicators and SYNTAX score,coronary artery stenosis score,and lesion characteristics score.Results The levels of serum LP(a)and Hcy in CHD group were higher than those in control group,and the level of HO-1 was lower than that in control group,the differences were statistically significant(P<0.05).The levels of serum LP(a)and Hcy in each subgroup of CHD group were in the order of low-risk group<middle-risk group<high-risk group(P<0.05),and the levels of serum HO-1 were in the order of low-risk group>middle-risk group>high-risk group(P<0.05).Pearson correlation analysis showed that the scores of coronary artery stenosis,lesion characteristics and SYNTAX scores in CHD patients were positively correlated with serum LP(a)and Hcy levels(P<0.05),and negatively correlated with HO-1 levels(P<0.05).Conclusion Serum LP(a)and Hcy levels in CHD patients are positively correlated with SYNTAX score,and HO-1 level is negatively correlated with SYNTAX score.All three indicators can be used to evaluate the degree of coronary artery disease,which is of great significance for the prevention,diagnosis and treatment of CHD.