冠心病患者血清同型半胱氨酸与冠脉侧支循环的关系  

Serum level of homocysteine and the development of collateral circulation in patients with severe coronary artery stenosis

作　　者：杨天崙[1] 贺琳[1] 李传昶[1] 蒲晓群[1] 郑昭芬[1] 邓金华[1] 孟双媛[1] 

机构地区：[1]中南大学湘雅医院心内科,长沙410008

出　　处：《中南大学学报（医学版）》2006年第5期655-658,共4页Journal of Central South University ：Medical Science

摘　　要：目的：探讨冠状动脉严重狭窄冠心病患者血清同型半胱氨酸浓度与冠状动脉侧支循环相关关系。方法：80例行冠脉造影示三支主要冠脉中至少有一支狭窄90％以上的冠心病患者，测定其血清同型半胱氨酸浓度；采用Rentrop方法对冠状动脉侧支循环进行分级。结果：单支、双支、三支血管病变组血清同型半胱氨酸浓度差异无统计学意义（P=0.926）；血清同型半胱氨酸浓度与Gensini积分无相关关系（r=-0.004，P=0．974）。侧支形成不良组血清同型半胱氨酸浓度明显高于侧支形成良好组（P〈0．001）。多元逐步Logistic回归分析显示冠脉侧支循环形成与血清同型半胱氨酸呈负相关（P〈0．001，OR值0．353，95％可信区间0.201～0．620），而与冠脉病变支数呈正相关。结论：冠状动脉严重狭窄病变的患者中血清同型半胱氨酸抑制冠脉侧支形成。Objective To investigate the relationship between serum level of homocysteine and the development of collaterals in patients with severe coronary artery stenosis （ SCAS ）. Methods Eighty patients with at least one vessel stenosis over 90 % among the 3 main vessels of coronary artery were consecutively enrolled into the study according to angiographic estimation. The development of collaterals was classified by Rentrop＇ s method. Results The serum levels of homocysteine among the single-vessel, bi-vessel and tri-vessel coronary artery disease gr. oups had no significant difference ; there was no linear correlation between the serum level of homocysteine and Gensini ＇ s score. The level of homocysteine in the poorly developed collaterals was significantly higher than that in the well-developed collaterals in the SCAS patients （P 〈 0. 001 ）. ＂Multiple stepwise logistic analysis revealed that homocysteine negatively correlated with the development of collaterals （ P 〈 0.001 , odds ratio = 0. 353 ; 95% confidence interval = 0. 201 - 0. 620 ） , whereas it positively correlated with the number of stenosis vessels. Conclusion The serum level of homocysteine is independently and negatively associated with the development of collateral circulation in severe SCAs patients.

关 键 词：侧支循环 冠状动脉疾病 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]