血浆同型半胱氨酸水平与冠状动脉病变程度的相关性研究

The relationship between plasma homocysteine and severity of coronary lesion

目的探讨血浆同型半胱氨酸水平与冠状动脉病变程度的关系。方法对因胸痛而行冠状动脉造影检查的91例患者,根据冠状动脉造影结果,分为冠心病组(1支以上主要血管狭窄程度≥50%)和正常对照组。并对血管病变行Gensini积分。取空腹静脉血利用高效液相层析法测定血浆同型半胱氨酸的浓度。分别比较冠心病组与正常对照组,冠状动脉单支、双支、三支血管病变与正常对照组之间血浆同型半胱氨酸水平有无差异。结果冠心病组高同型半胱氨酸血症的检出率高于对照组(46.4%vs10%,X2=12.1,P【0.01)。不论是单支、双支、还是三支血管病变,其血浆同型半胱氨酸水平均高于正常对照组(P【0.01)。其中,三支血管病变组高于单支或双支病变组(P【0.05)。而单支、双支血管病变组之间差异无显著性(P】0.05)。血浆同型半胱氨酸水平随着Gensini积分的增加而升高。结论冠心病患者血浆同型半胱氨酸水平明显升高,高同型半胱氨酸血症的检出率高。随着冠状动脉病变支数增加,血浆同型半胱氨酸水平有逐步升高的趋势。血浆同型半胱氨酸水平与冠状动脉病变的严重程度一致。

ObjectiveTo investigate the relationship between plasma homocysteine and severity of coronary lesion.MethodsNinty-one patients(69 men and 22 women) were divided into coronary artery disease group(71 patients) and control(20 patients)group by the results of coronary angiography. Gensini scoring was calculated to the lesions of coronary artery. Plasma total homocysteine concentration was determined by high performance liquid chromatography (HPLC) method with fluorescence detection. To compare the different of plasma total homocysteine levels between the coronary artery disease and control group, also single-vessel, double-vessel , triple-vessel and control groups. Results More cases of hyperhomo-cysteinemia were found in coronary artery disease patients than in the controls (46.4 % vs 10 % , X+2 12.1, P<0.01 ). The mean plasma total homocysteine levels in patients among control group, single-vesse, double-vessel and triple-vessel disease were singnificantly different (P<0.01 ). Plasma total homocystein levels were the highest in patients with triple-vessel lesions(P<0.01). Plasma total homocysteine levels in patients with lesion of single-vessel or doubl-vessel were higher than those with controls(P<0.05), but no difference was noted between lesions of single-vessel and doubl-vessel group (P> 0.05). Plasma homocysteine levels was increased with Gensini scoring. Conclusion Patients with coronary artery disease have higher total homocysteine level and more hyperhomocysteinemia than the controls. There is a trend of increased total homocysteine levels with the range and severity of coronary artery.