同型半胱氨酸在冠心病患者中的诊断价值

Diagnostic value of homocysteine in coronary heart disease

目的探讨同型半胱氨酸(Hcy)在冠心病(CHD)患者中的诊断价值。方法选择102例CHD患者[急性心肌梗死(AMI)15例,不稳定性心绞痛(UAP)56例,稳定性心绞痛(SAP)31例]为CHD组,100例健康成人为对照组,分别用循环酶法测定血清Hcy水平,用微粒子化学发光免疫分析法测定叶酸(FA)和维生素B12(VB12)水平。结果 AMI组、UAP组和SAP组的Hcy水平,分别为(24.12±5.87)μmol/L、(22.56±6.13)μmol/L、(17.42±5.23)μmol/L,均明显高于对照组(P<0.01)。CHD患者和对照组中Hcy水平均为男性高于女性,高龄组高于低龄组,吸烟组高于非吸烟组,差异均有统计学意义(P<0.01)。Hcy水平与FA和VB12水平均呈负相关,相关系数(r)分别为-0.62和-0.47(P<0.01)。结论高Hcy血症与CHD发病关系密切,Hcy可作为CHD病变的预警指标。对男性、吸烟和高龄CHD患者,应定期检测Hcy。

Objective To study the diagnostic value of homocysteine (Hcy) in coronary heart disease(CHD) .Methods 102 CHD patients were collected as CHD group [15 cases of acute myocardial infarction (AMI) ,56 cases of unstable angina pectoris (UAP) and 31 cases of table angina pectoris (SAP)] and 100 healthy subjects were collected as control group .The level of Hcy was measured by enzymatic cycling assay and the levels of folic acid (FA) and vitamin B12 (VB12 ) were measured by microparticle chemoluminescence immunoassay .Results The Hcy levels of patients with AMI ,UAP and SAP were significantly higher than con-trol group (P<0 .01) .The levels of AMI group ,UAP group and SAP group were (24 .12 ± 5 .87)μmol/L ,(22 .56 ± 6 .13)μmol/L and (17 .42 ± 5 .23)μmol/L ,respectively .Not only in CHD group ,but also in control group ,the level of Hcy in men was signifi-cantly higher than that in women .Similarly ,the level of Hcy were significantly higher in current smokers compared with non-smok-ers as well as in older group compared with young group .There were significant negative correlations between Hcy and FA (r= -0 .62 ,P<0 .01) and VB12 (r= -0 .47 ,P<0 .01) .Conclusion Hyperhomocysteinemia is significantly associated with CHD .Hcy may be an marker for early warning CHD .