冠心病的强预报因子:高同型半胱氨酸血症  

Powerful predictor of coronary heart disease:hyperhomocysteinemia

作　　者：廉玉蓉[1] 高东来[1] 鹿育萨[1] 

机构地区：[1]山西医科大学第二临床医院心内科,山西省太原市030001

出　　处：《中国临床康复》2005年第27期121-123,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:了解同型半胱氨酸血症与冠心病发生发展的关系。资料来源:应用计算机检索Medline数据库1985-01/2004-10关于同型半胱氨酸和冠心病的文章,检索词“homocysteine,coronaryheartdisease”,限定文章语言的种类为英文。同时计算机检索中国期刊全文数据库1994-01/2004-10关于同型半胱氨酸和冠心病的文章,检索词为“同型半胱氨酸,冠心病”,限定语言种类为中文。资料选择:对资料进行初审,选择包括处理组和对照组文献,筛除明显不随机的研究,对剩余文献开始查找全文,进一步判断是否为随机对照研究。纳入标准为①随机对照研究。②实验或临床研究包含平行对照组。排除标准:重复性研究和综述类文章。资料提炼:共收集到60篇关于胆红素抗氧化的随机和未随机的文章,18个实验或临床研究纳入标准。排除的42篇实验均为重复研究。资料综合:高同型半胱氨酸血症可增加患冠心病的危险性。高同型半胱氨酸血症参与冠心病的发生发展可能与如下因素有关:高同型半胱氨酸血症导致内皮细胞损伤、影响内皮细胞的凝血作用,高同型半胱氨酸血症可促进平滑肌细胞的增殖、促进平滑肌细胞胶原的合成。同型半胱氨酸可以把载脂蛋白A从脂蛋白(a)复合物中分离,导致载脂蛋白A上附加的赖氨酸结合位点暴露,此位点可增加载脂蛋白A与纤维蛋白的亲合力,抑制纤溶酶原与纤维蛋白结合,从而抑制纤维蛋白溶解,加速动脉粥样斑块的形成。此外,同型半胱氨酸还有增强脂质氧化的作用。同型半胱氨酸可以通过促进内皮细胞介导的凝血系统加速血栓的形成,还可使血小板受损。结论:高同型半胱氨酸血症是冠心病的独立危险因素。高同型半胱氨酸血症可通过多种途径参与冠心病的发生发展。OBJECTIVE： To investigate the association of hyperhomocysteinemia with the occurrence and development of coronary heart disease. DATA SOURCES： An online search of Medline database was applied with the keywords of＂homocysteine, coronary heart disease＂to identify the articles about homocysteine and coronary heart disease published in English from January 1985 to October 2004. Meanwhile, Chinese articles about homocysteine and coronary heart disease published between January 1994 and October 2004 were searched with computer in the China journal full-text database with the keywords of ＂homocysteine, coronary heart disease＂. STUDY SELECTION： The data were checked preliminarily, the articles including treatment group and control group were selected, and the obvious non-randomized- studies were excluded, and then the full-texts of the rest articles were looked up to further judge whether randomized control study or not. Inclusion criteria： ① randomized control study; ② experiment or clinical study including parallel control group. Exclusion criteria： repetitive studies and reviews. DATA EXTRACTION： Totally 60 randomized and non-randomized articles about the anti-oxidation of bilimbin were collected, 18 experiments or clinical studies met the inclusion criteria, and the 42 excluded experiments were all repetitive studies. DATA SYNTHESIS： Hyperhomocysteinemia can increase the risk of coronary heart disease. Hyperhomocysteinemia was involved in the occurrence and development of coronary heart disease, and might be associated with the following factors： Hyperhomocysteinemia resulted in the injury of endothelial cells, and affected the blood coagulation of endothelial cells; Hyperhomocysteinemia could accelerate the proliferation of smooth muscle cells and the synthesis of smooth muscle cell collagen. Homocysteine could isolate apolipeprotein A from the compound of lipeprotein （a）, and then led to the exposure of lysine conjugative site added to apelipeprotein A, and the site could increase th

关 键 词：冠状动脉疾病 半胱氨酸 综述文献 

分 类 号：R541.4[医药卫生—心血管疾病]