同型半胱氨酸硫内酯复合物与冠心病关系的研究  

The correlation between plasma homocvsteine thiolactone adducts and coronary heart disease and the study on its pathogenesis

作　　者：周瑾[1] 高岩[1] 惠汝太 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院分子医学中心,北京100037

出　　处：《中国分子心脏病学杂志》2003年第1期32-35,共4页Molecular Cardiology of China

摘　　要：目的 探讨血浆同型半胱氨酸硫内酯(Homocysteine thiolactone,HTL)复合物水平与冠心病(CHD)及其病程的相关性,HTL复合物与同型半胱氨酸(Homocysteine,Hcy)及传统危险因素的作用及其致病机制。方法 选择CHD患者177例,全部经冠状动脉造影证实,正常对照组177例,全部为正常查体人群。竞争性ELISA方法测定血中HTL复合物的含量,HPLC方法测定血中Hcy的含量。结果 CHD组HTL复合物水平明显高于对照组[(28.57±9.6)u/ml比(24.95±8.95)u/ml,P<0.01].CHD组高HTL复合物血症的发生率明显高于对照组(18.6％比9.6％,P<0.05),且在低Hcy血症的CHD患者中,高HTL复合物血症的阳性率仍较对照组显著升高(22.3％vs.9.6％,P<0.01)。多元logistic回归分析显示,HTL复合物对CHD的相对危险度(OR)为2.315(95％可信区间:1.129～4.746,P<0.05)。相关性分析结果表明,HTL复合物与Hcy不具有明显相关性,但与冠状动脉血管堵塞程度呈正相关(R～0.209,P<0.001)。以HTL复合物为因变量进行多元线性回归分析显示,HTL复合物与冠状动脉血管堵塞程度及心梗史具有直线关系。结论 HTL复合物是CHD的独立危险因素。HTL复合物水平可反映冠状动脉血管堵塞的严重程度。objective To investigate the correlation between plasma homocysteine thiolactone （HTL） adducts and coronary heart disease （CHD）, to estimate the relationship among plasma HTL adducts, Hey and some established cardiovascular risk factors and to probe probable pathogenesis of HTL adducts. Methods In 177 patients with CHD who was verified by coronary angiograms （CHD group） and 177 control subjects without CHD, the serum HTL adducts were measured by ELISA and the plasma Hey by HPLC. Results The plasma HTL adducts level was significantly higher in CHD cases than in the control [ （28.57 ± 9.6）u/ml vs. （24.95 ± 8.95）u/ml, P〈0.011. And there was a significantly higher incidence rate of high plasma HTL adducts level in case group than those in control group （18.6% vs. 9.6%, P〈0.05）, especially in hypohomocysteinemia of case group than those in control group 122.3 % vs. 9.6 %, P〈0.011. Based on multiple stepwise logistic regression analylsis, the odds ratio （OR） of HTL adducts to CHD was 2. 097 （95 % CI： 1.118-3. 932, P（0.05）. Bivariate Correlations analysis showed that HTL adducts had no significant correlations with Hey, but significantly correlated with the severity of coronary artery diseas（R = 0.209,P（0.001 ）. Conclusion HTL adducts are relative with CHD and high level of plasma HTL adduct is a independent risk factor of CHD,and the level of HTL adducts is correlated with the severity of coronary artery disease.

关 键 词：同型半胱氨酸硫内酯复合物 冠心病 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]