血清同型半胱氨酸水平与年龄、冠脉病变支数及冠心病不同类型之间的关系

The relationship among serum homocysteine, age, type of coronary heart disease and the branches of coronary arteriopathy

目的 了解血清同型半胱氨酸 (Hcy)水平与年龄、冠状动脉 (冠脉 )病变支数及冠心病不同类型之间的关系。 方法 采用横断面调查的方法收集行冠状动脉造影术的年龄≥ 6 0岁 (老年组 )者 16 6例 ,年龄低于 6 0岁 (非老年组 )者 16 1例 ;从健康查体人群中选取 6 3人做为健康对照组 ,用高效液相色谱测定血清Hcy水平。 结果 冠心病患者男性的比例、年龄及血清Hcy水平高于非老年组冠心病患者 ;老年组冠心病患者的血清Hcy〔(17 6 3± 7 12 ) μmol/L〕水平低于非老年组〔(2 0 82± 13 31) μmol/L〕 ,P <0 0 5 ;老年组冠心病患者的女性比例 (2 8/ 16 6 )明显高于非老年组的比例 (8/16 6 ) ,且P <0 0 5。老年组与非老年组患者Hcy水平明显高于非冠心病组 (P <0 0 1)。老年组 2支及 3支病变组Hcy水平高于 1支病变组 (P <0 0 5 )。进一步观察Hcy水平与冠心病不同类型之间的关系发现 ,老年组冠心病不同类型之间的Hcy水平差异无显著性 (P >0 0 5 )。 结论 血清Hcy升高、男性和年龄是导致冠脉病变的重要而独立的危险因素之一 ,年龄对血清Hcy水平有一定的影响 ;Hcy水平轻度升高做为判断冠状动脉病变严重程度的指标在老年组冠心病患者有一定意义 ;做为判断冠心病的不同临床类型的指标在非老年组冠心病患者?

Objective To investigate the significance of homocysteine (Hcy) in pathogenesis of coronary heart disease (CHD) and the relationship among serum homocysteine , age, type of CHD and the branches of coronary arteriopathy. Methods In a cross sectional test, serum Hcy levels of 166 old cases (age≥60 years) and 161 non old cases(age<60 years) undergoing coronary arteriography and 63 healthy people were measured using high-performance liquid chromatography(HPLC)with fluorescence detection. Results Coronary atherosclerosis was correspondingly related with male, aging and elevated Hcy level. The mean serum Hcy level was significantly lower in old CHD patients 〔(17.63±7.12)μmol/L〕 than in non old CHD patients 〔(20.82±13.31)μmol/L 〕, P<0.05. The mean serum Hcy level was higher in old CHD patients with 2 and 3 branches of arteripathy than 1 branch of arteriopathy, P<0.05. Hcy level was similar in old CHD patients between different CHD types. Conclusions The results show that elevated Hcy level,male and aging were independent risk factors in the development of atherosclerosis. Age has the definite impact on Hcy level. There is relationship between Hcy level and the branches of coronary arteriopathy in old CHD patients. There is relationship between Hcy level and the type of CHD in non old CHD patients.