不同类型冠心病患者血清同型半胱氨酸水平变化研究

Correlation between Homocysteine and Different Types of Coronary Heart Disease

背景最新研究发现同型半胱氨酸(Hcy)是引起动脉粥样硬化新发现的危险因素,与心血管疾病的发生密切相关。目的探讨不同类型冠心病患者血清Hcy水平变化及其与其他实验室检查指标的相关性。方法选择2015—2017年宁夏医科大学总医院心内科住院确诊为冠心病的患者1 303例为研究对象,根据冠心病类型分为ST段抬高型心肌梗死(STEMI)组311例,非ST段抬高型心肌梗死(NSTEMI)组254例,不稳定型心绞痛(UAP)组503例,稳定型心绞痛(SAP)组235例,另选择同期非冠心病者242例为对照组,比较各组一般资料及实验室检查指标,采用Pearson直线相关分析各组Hcy水平与其他实验室检查指标的相关性。结果各组性别、年龄、吸烟史、高血压及糖尿病检出率、Hcy、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)水平比较,差异均有统计学意义(P<0.05)。相关性分析显示STEMI组Hcy与HbA1c呈正相关(P<0.05);NSTEMI组Hcy与TG呈正相关(P<0.05);UAP组Hcy与HDL-C呈负相关(P<0.05),与Lp(a)呈正相关(P<0.05);SAP组Hcy与TC呈正相关(P<0.05)。结论 Hcy与冠心病疾病严重程度存在密切联系,具有重要的临床诊断价值。

Background The latest study found that homocysteine(Hcy) is a newly discovered risk factor of atherosclerosis and is closely related to the occurrence of cardiovascular disease.Objective To investigate the correlation between serum Hcy and different types of coronary heart disease(CHD).Methods A total of 1 303 patients with CHD admitted to General Hospital of Ningxia Medical University were retrospectively analyzed from 2015 to 2017,which included 311 cases of ST-elevation myocardial infarction(STEMI),254 cases of non ST-elevation myocardial infarction(NSTEMI),503 cases of unstable angina pectoris(UAP),235 cases of stable angina pectoris(SAP) and 242 cases of control group.General information and laboratory indexes of each group were compared,and Pearson linear correlation analysis was used to analyze the correlation between Hcy level and other laboratory indexes.Results There were significant differences in sex,age,smoking history,hypertension and diabetes detection rate,Hcy,triglyceride(TG),total cholesterol(TC),highdensity lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),lipoprotein(a) [Lp(a)],glycosylated hemoglobin(HbA1 c),C-reactive protein(CRP)(P<0.05);Pearson linear correlation analysis showed that Hcy in STEMI group was positively correlated with HbA1 c(P<0.05),Hcy in NSTEMI group positively correlated with TG(P<0.05),Hcy in UAP group negatively correlated with HDL-C(P<0.05) and positively correlated with Lp(a)(P<0.05),and Hcy in SAP group positively correlated with TC(P<0.05).Conclusion Hcy is closely related to the severity of CHD and has important clinical diagnostic value.