同型半胱氨酸与急性冠脉综合征的关系及药物干预的影响  

Correlation between level of homocystine and acute coronary syndrome and its intervention of drug

作　　者：李艳丽[1] 杨连峰[1] 金军英[2] 孙淑梅[1] 宁国贤 张英萍[1] 王建华[1] 纪东华[1] 毛红岩[1] 刘丽[1] 

机构地区：[1]黑龙江省佳木斯市中心医院心内二科,154002 [2]黑龙江省佳木斯市中心医院检验科

出　　处：《心血管康复医学杂志》2006年第5期450-452,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血浆同型半胱氨酸(H cy)水平与急性冠状动脉综合征(ACS)的关系,并应用药物干预,观察药物对血浆H cy水平的影响。方法:87例ACS患者及97例稳定性心绞痛患者(对照组),均在住院第二日晨采集静脉血检测H cy,总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C)水平,两组进行对比分析。第三日起给予ACS组高H cy患者口服叶酸、维生素B6,观察用药后4周、8周的血浆H cy变化。结果:ACS组H cy水平明显高于稳定性心绞痛组(对照组),P<0.01;而两组的TC、TG、HDL-C、LDL-C水平却无显著性差异(P>0.05)。用药后4周ACS组36例(44.45%)患者H cy水平下降至正常,8周后ACS组患者H cy水平全部降至正常。结论:ACS患者的H cy与血脂水平并不相关,是独立于传统危险因素之外的又一主要危险因素,应用叶酸、维生素B6治疗,H cy可于8周后全部降至正常水平,可用于ACS的一级预防用药。Objective：To explore the correlation between level of homoeystine and acute coronary syndrome （ACS） and effect of drug intervention for level of homocystine. Methods： The levels of homocystine （Hcy）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein-cholesterol （HDL-C）, low density lipoprotein-cholesterol （LDL- C） were estimated in 87 ACS patients （ACS group） and 97 patients with stable angina pectoris （SAP. control group） and compared between ACS and SAP patients. The ACS patients with Hcy level increase were accepted folic acid and Vit B6 for 8 weeks. Results：The Hcy levels of ACS group was more than that of SAP group （P〈0.01）, but the levels of TC. TG. HDL-C and LDL-C were no significant difference between two groups （P〉0.05）. After 4 weeks therapy of folic acid and Vit B6 the Hcy levels significantly decreased （19.46±6.38μmol/L. P〈0.05） and of 36 ACS patients （44.45 %） decreased to normal level; continue therapy to 8 weeks, that Hcy levels significantly decreased （11.68±4.23 μmol/L） and of all ACS patients decreased to normal level. Conclusion： There is no significant correlation between Hcy and lipid level in patient with ACS; the Hcy level increase is an independence principal risk factor of coronary artery disease except traditional risk factor. For hyperhomocystinemia the effect of folic acid and Vit B6 therapy is very good, may use for primary prevention.

关 键 词：高半胱氨酸 冠状动脉疾病 叶酸 维生素B6 

分 类 号：R541.409[医药卫生—心血管疾病]