冠心病患者血浆同型半胱氨酸变化及叶酸的干预治疗

The level of Plasma Homocysteine in Patients with Coronary Artery Disease and Interventional Therapy of Folic Acid

目的 了解血浆同型半胱氨酸(Homocysteine,Hcy)、叶酸和维生素(Vit)B12水平与冠心病的关系;观察叶酸干预治疗高Hcy血症的疗效.方法 经冠脉造影确诊的冠心病患者97例、亚冠心病患者58例及完全正常31例,用高效液相色谱法测血浆Hcy水平,用放免法测血浆叶酸和VitB12浓度.其中高Hcy血症病人每天服用叶酸5mg,观察4周和8周后血浆Hcy水平变化.结果 冠心病和亚冠心病患者血浆Hcy水平明显高于正常人,叶酸和VitB12水平则明显下降;冠心病患者冠脉病变支数越多,血浆Hcy升高和叶酸、VitB12下降越明显;叶酸治疗高Hcy血症患者4周和8周,分别使血浆Hcy水平下降12.5%和38.5%.结论 冠心病和亚冠心病患者血浆Hcy水平明显升高,高Hcy血症是冠心病的危险因素之一.血浆Hcy水平变化与冠脉病变程度正相关.叶酸干预治疗可使高Hcy血症患者血浆Hcy浓度明显降低.

ObjectiveTo Study the relationship of plasma homocysteine(Hcy),folic acid and VitB12 with Coronary artery disease (CAD) and effects of interventional therapy of folic acid to the patients with hyperhomocysteinemia. MethodThe plasma Hcy levels of 97 cases with CAD and 58 cases with SubCAD and 31 subjects without CAD were measured by using highperformance liquid chromatography(HPLC) with fluorescence detection.Plasma folic acid and VitB12 levels were measured with radioassay method. The patients with hyperhomocysteinemia were treated with 5mg of folic acid for 8 weeks, then rechecked plasma Hcy, folic acid and VitB12 4th and 8th week after the treatment. ResultsThe plasma Hcy level was significantly higher in the CAD and subCAD patients than in the controls . The plasma folic acid and VitB12 were significantly lower in the CAD patients than in the controls. The Hcy level in the triplevessel group with that in the singlevessel group.The Hcy level in 61 patients with CAD and subCAD was significantly reduced by 12.5%(4 th week) and 38.5%(8 th week ) after 8week folic acid adminstration. ConclusionHcy level is elevated in patients with CAD and subCAD. Hyperhomocysteinemia plays an important role in the pathogenesis of CAD. Folic acid can reduce plasma Hcy level of CAD and subCAD patients with hyperhomocysteinemia.