血浆同型半胱氨酸与冠状动脉病变的关系探讨.pdf

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1、·888·疑难病杂志2014年9月第13卷第9期ChinJDifficandComplCas，September2014，Vo1．13No．9【摘要】目的探讨冠心病患者血浆同型半胱氨酸(Hcy)与冠状动脉病变程度的关系。方法选择行冠状动脉造影确诊为冠心病患者178例为冠心病组，并根据病变支数分为1支病变亚组(48例)，2支病变亚组(57例)，≥3支病变亚组(73例)。选择同期行冠状动脉造影检查正常者48例为非冠心病组。检测并比较2组患者血浆Hey水平、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)，并测定冠心病组冠状动脉狭窄程度，记录Gensini冠状动脉病变积分。结果冠心病

2、组血浆Hcy水平、TC、TG均高于非冠心病组，HDL低于非冠心病组，差异均有统计学意义(P<0．05)。冠心病患者随着冠状动脉病变程度的加重，血浆Hey水平和Gensini评分均逐渐增加，1支病变亚组<2支病变亚组<1>3支病变亚组，与非冠心病组比较差异均有统计学意义(P<0．05)。Hey、TC、TG是冠心病的危险因子，而HDL是冠心病的保护因子(P<0．05)。结论高Hcy是冠心病独立危险因素，随着冠状动脉病变程度加重而升高，可通过检测Hcy水平评价冠状动脉病变程度。【关键词】同型半胱氨酸；冠状动脉病变；Gensini评分【DOI】10．3969／J．issn．1671-6450．2

3、014．09．003StudyontherelationshipbetweenplasmahomocysteineandcoronaryarterylesionsWANGHuiqing，WANGYanna，JINYaolai，DENGChenghui．DepartmentofCardiology．AffiliatedZhongshanHospitalofDalianUniversity，Dalian116011．China【Abstract】ObjectiveToinvestigatethecorrelationbetweenplasmahomocysteineinpatientswit

4、hcoronaryarterydisease(Hcy)associatedwiththeseverityofcoronaryarterylesion．Methods178patientswithcoronaryangiographycon—finnedcoronaryheartdiseasewereenrolledasCHDgroup，andaccordingtothenumberofdiseasedarteries，theyweredivid—edinto1vesseldiseasesubgroup(48cases)，2-vesseldiseasesubgroup(57cases)，3

5、-vesseldiseasesubgroup(73cases)．Thesameperiod48casesofnormalpatientswereselectednon—CHDgroup．LevelsofplasmaHcy，totalcholesterol(TC)，threetriacylglycerol(TG)，highdensitylipoprotein(HDL)weredetectedandcomparedbetweenthe2groups，andtodeter·minetheextentofcoronaryarterystenosis，recordtheGensinicoronar

6、yarteryscore．ResultsThelevelsofplasmaHcy，TC，TGofcoronaryheartdiseasegroupwerehigherthanthatinnonCHDgroup，HDLwaslowerthanthatinnonCHDgroup，thedifferenceswerestatisticallysignificant(P<0．05)．Coronaryheartdiseasepatientsalongwiththeseverityofcoronaryarterydisease，plasmaHeylevelandGensiniscorewereinc

7、reased，1vesseldiseasesubgroup<2vesseldiseasesubgroup<3yes—seldiseasesubgroup，anddifferencesbetweenformerandnonCHDgroupwerestatisticallysignificant(P<0．05)．LogisticregressionanalysisrevealedthatHcy，TC，TGwereriskfactorso