血浆同型半胱氨酸和尿酸及高敏C反应蛋白与冠状动脉粥样硬化性心脏病的相关性分析

Correlation between plasma levels of homocysteine,uric acid,hypersensitive C-reactive protein and coronary atherosclerotic heart disease

目的探讨血浆同型半胱氨酸(Hcy)、尿酸及高敏C反应蛋白(hs-CRP)水平与冠状动脉粥样硬化性心脏病(冠心病)之间的相关性。方法回顾性分析2017年8月至2018年10月因疑似冠心病在北京市门头沟区医院住院患者205例,根据冠状动脉造影结果分为非冠心病组(35例)和冠心病组(170例),冠心病组患者再根据冠状动脉病变严重程度分为单支病变组(56例)、双支病变组(64例)和三支病变组(50例)。比较各组间血浆Hcy、尿酸、hs-CRP和血脂水平,分析血浆Hcy、尿酸、hs-CRP水平与冠状动脉病变严重程度的相关性。结果冠心病组患者血浆Hcy、尿酸及hs-CRP、三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)水平明显高于非冠心病组[(24. 0±8. 0)μmol/L比(8. 6±1. 6)μmol/L、(455±60)μmol/L比(249±48)μmol/L、(11. 0±3. 8) mg/L比(5. 1±1. 0) mg/L、(2. 9±0. 7) mmol/L比(1. 4±0. 6) mmol/L、(6. 0±1. 8) mmol/L比(4. 0±0. 6) mmol/L、(4. 1±0. 8) mmol/L比(1. 6±0. 5) mmol/L],高密度脂蛋白胆固醇(HDL-C)水平明显低于非冠心病组[(0. 9±0. 4) mmol/L比(2. 6±0. 4) mmol/L],差异均有统计学意义(均P <0. 001)。双支病变组和三支病变组患者Hcy、尿酸及hs-CRP水平均明显高于单支病变组,三支病变组总胆固醇、LDL-C水平均明显高于单支病变组,差异均有统计学意义(均P <0. 05);而3组间三酰甘油及HDL-C水平比较差异均无统计学意义(均P> 0. 05)。血浆Hcy、尿酸、hs-CRP水平与冠心病患者冠状动脉病变严重程度均呈正相关(r=0. 723、0. 697、0. 774,均P <0. 001)。结论血浆Hcy、尿酸、hs-CRP水平与冠状动脉病变严重程度成正相关,对冠心病的诊断有一定的预测价值。

Objective To explore the correlation of plasma levels of homocysteine( Hcy),uric acid( UA),hypersensitive C-reactive protein( hs-CRP) and coronary atherosclerotic heart disease( CHD). Methods Clinical data of 205 patients who were suspiciously diagnosed as CHD in Beijing Mentougou District Hospital between August 2017 to October 2018 were retrospectively retrieved. According to coronary angiography results,the patients were divided into no-CHD group( 35 cases) and CHD group( 170 cases). According to the severity of coronary artery lesion,they were divided into single-lesion group( 56 cases),dual-lesion group( 64 cases) and triple-lesion group( 50 cases). Plasma levels of Hcy,UA,hs-CRP and blood lipids were recorded. Correlation between the indicators and severity of CHD was analyzed. Results Levels of Hcy,UA,hs-CRP,triglyceride,total cholesterol and low-density lipoprotein cholesterol( LDL-C) in CHD group were significantly higher than those in non-CHD group[( 24. 0 ± 8. 0) μmol/L vs( 8. 6 ± 1. 6) μmol/L,( 455 ± 60) μmol/L vs( 249 ± 48) μmol/L,( 11. 0 ± 3. 8) mg/L vs( 5. 1 ± 1. 0) mg/L,( 2. 9 ± 0. 7) mmol/L vs( 1. 4 ± 0. 6) mmol/L,( 6. 0 ± 1. 8) mmol/L vs( 4. 0 ± 0. 6) mmol/L,( 4. 1 ± 0. 8) mmol/L vs( 1. 6 ± 0. 5) mmol/L];level of high-density lipoprotein cholesterol( HDL-C) in CHD group was significantly lower than that in non-CHD group[( 0. 9 ± 0. 4) mmol/L vs( 2. 6 ±0. 4) mmol/L]( all P < 0. 001). Levels of Hcy,UA and hs-CRP in dual-lesion group and triple-lesion group were significantly higher than those in single-lesion group;levels of total cholesterol and LDL-C in triple-lesion group were significantly higher than those in single-lesion group( all P < 0. 05);levels of triglyceride and HDL-C showed no significant difference among the three groups( all P > 0. 05). Levels of plasma Hcy,UA and hs-CRP were positively correlated with the severity of coronary artery disease( r = 0. 723,0. 697,0. 774,all P < 0. 001).Conclusion Plasma levels of Hcy,UA and hs-CRP were positively correlated with the severity of coronary artery lesion,indicating possible predictive value for the diagnosis of CHD.