冠状动脉病变患者血清同型半胱氨酸和非高密度脂蛋白胆固醇检测  

The determination of serum homocysteine and non-high-density lipoprotein cholesterol in patient with coronary atherosclerotic disease

作　　者：许翔[1] 陆元善[1] 

机构地区：[1]上海交通大学附属第一人民医院检验科,上海200080

出　　处：《检验医学》2006年第4期324-327,共4页Laboratory Medicine

摘　　要：目的 探讨血清同型半胱氨酸（Hcy）和非高密度脂蛋白胆固醇（non—HDL—C）的水平与冠状动脉病变（CAD）程度的关系。方法 选取299例60～75岁无糖尿病史及肾功能损伤的冠状动脉造影阳性患者，94例无糖尿病史及肾功能损伤的冠状动脉造影阴性者，分别测定总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、载脂蛋白A—I（apoA—I）、载脂蛋白B（apoB）、载脂蛋白E（apoE）、脂蛋白（a）[Lp（a）]及Hcy。并通过Frost法计算出non—HDL—C。结果 冠状动脉造影阳性患者的non—HDL—C显著高于冠状动脉造影阴性者（P〈0.01），并且随冠状动脉狭窄支数的增加而升高。冠状动脉造影阳性患者的Hcy显著高于冠状动脉造影阴性者（P〈0．01），并且随冠状动脉狭窄支数的增加而升高。冠状动脉造影阳性患者的non—HDL—C与Hcy无相关性（r=0．281，P〉0。05）。结论 高浓度的血清Hcy及non—HDL—C水平是CAD的危险指标。血清Hcy浓度与non—HDL—C水平之间无相关性。血清Hey和non—HDL—C与Lp（a）三者同时检测是评价和预测CAD的可信且敏感的指标。Objective To investigate the relationship between the serum levels of homocysteine （ Hcy ） and non-high-density lipoprotein cholesterol （non-HDL-C） and the severity of coronary atherosclerotic disease （CAD）. Methods The serum levels of total cholesterol （TC）, trigleceride （TG）, high-density lipoprotein cholesterol （HDL-C） , low-density lipoprotein cholesterol （ LDL-C）, apolipoprotein A- I （ apo A- I ）, apolipoprotein B （ apo B）, apolipoprotein E （apo E） ,lipoprotein（a） [ Lp（a）] and Hcy were determined in 299 patients with no diabetes and no renal function injury and angiographic postive patients （age 60-75 ） ,and 94 angiographic negative controls （age 60-75 ）. Non-HDL-C concentration was calculated with Frost formula. Results The serum level of non-HDL-C in angiographic positive group was higher than it in negative group （P 〈0.01 ） and increased with the severity of coronary stenosis. The serum level of Hcv in angiographic positive group was significantly higher than it in negative group （P 〈 0.01 ）, and increased with theseverity of coronary stenosis. There was no relationship between serum non-HDL-C and Hcy in angiographic positive group （r = 0.281 ,P 〉 0.05 ）. Conclusions Higher concentrations of serum Hcy and non-HDL-C are the risk factors for CAD. The serum levels of Hcy, non-HDL-C and Lp（a） are sensitive and reliable indexes for evaluating and predicting CAD.

关 键 词：非高密度脂蛋白胆固醇 同型半胱氨酸 冠状动脉病变 

分 类 号：Q513[生物学—生物化学]