国人血浆总同型半胱氨酸水平与冠心病关联  

Plasma homocysteine Associated with Coronary Heart Disease in Chinese

作　　者：张春玲[1] 鞠振宇[1] 孙静[1] 刘晓宁[1] 高润林[2] 陈纪林[2] 杨跃进[2] 惠汝太 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院一中德分子医学研究室,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室,北京100037

出　　处：《中国分子心脏病学杂志》2003年第4期215-222,共8页Molecular Cardiology of China

摘　　要：目的 探讨血浆总同型半胱氨酸水平升高是否增加国人冠心病(CHD)的危险。方法 分析1698例经冠状动脉造影确诊的CHD患者、302例冠状动脉造影阴性者及500名健康人的血浆总同型半胱氨酸、血脂及血糖水平与CHD及其它危险因素的关系。结果:(1)CHD组男女患者的血浆总同型半胱氨酸水平及异常检出率(％)[男:16.43±1.60μmol/L,(51.3％);女:14.38±11.51μmol/L,(39.3％]均明显高于冠造阴性组(男:13.70±1.49μmol/L,(34.1％);女:12.27±1.39μL,(22.0％)及健康对照组(男:12.37±1.32μmol/L,(24.7％);女:10.65±1.31μmol/L,(10.0％),且急性心肌梗死组>陈旧性心肌梗死组>心绞痛组(P<0.001)同时,CHD组患者的吸烟、冠心病家族史、高血压及糖尿病的百分率和总胆固醇、LDL-C水平等亦明显高于,而HDL-C水平却明显低于健康对照组及冠造阴性组(P<0.01)。(2)各组男性总同型半胱氨酸水平及异常检出率(％)均高于女性;男性CHD患者的高同型半胱氨酸血症患病率和同型半胱氨酸中、重度增高率分别是女性的1.31和1.56倍(P<0.001);且男性健康者及女性CHD患者的总同型半胱氨酸水平与年龄之间有明显正相关性(r=0.258,P<0.001 andr=0.129,P<0.05)。(3)CHD组高同型半胱氨酸血症患者血浆总同型半胱氨酸水平(22.68±1.50μmol/L,)亦明显?Abstract Objective To investigate whether the elevated plasma total homocysteine （tHcy） increases the risk of coronary heart disease （CHD） in Chinese. Methods The plasma levels of tHcy, lipid and glucose were analysed in 2000 patients underwent coronary angiography,1698 of the 2000were,diagnosed as CHD, 302,non-CHD, and 500 sex- and age- matched healthy subjects as control. Conventional risk factors for CHD were recorded as well. Results （I） The plasma tHcy level and incidence （%） of hyperhomocysteinemia were significantly higher in CHD group [male：16.43±1.60μmol/L, （51.3%） ;female： 14.38±1.51μmol/L, （39.3%）] than non-CHD group [male：13.70±1.49μmol/L （34.1%） ; female： 12.27±1.39μmol/L （22.0%）] and normal controls [male：12.37±1.32μmol/L （24.7%） ; female： 10.65±1.31 μmol/L （10.0%）] （P〈0.001） . Patients with CHD were subgrouped into acute myocardial infarction （AMI） , old myocardial infarction （OMI） and angina peetoris （AP） groups, The level of tHey was much higher in AMI group than OMI and AP groups （P〈0.001） . Patients with CHD also had more traditional risk factors （ TC, LDL-C and smoking, family history of CHD, hypertension and diabetes and lower HDL-C ） than those of non-CHD group and normal controls. Male subjecets had higher tHey than that of female subjects （P〈0.01） . A positive correlation between plasma tHey levels and age was present in the men in normal controls and in the women in CHD group （r=0.258, P〈0.001 and r=0.129, P 〈 0.05） .The tHey level was negatively correlated with glucose level （P〈0.02） , but not lipid levels. Multiple stepwise logistic regression analysis showed that tHey. were still significantly associated with CHD after adjusted the conventional risk factors, Compared with the normal controls, the odds ratio was 6.57 （95%CI： 4.24-10.19, P〈0.001） and 3.95 （95%CI： 2.79-5.59, P〈0.001） for the AMI group and OMI group, respectively, AMI group 〉 OMI group 〉 AP

关 键 词：冠心病 同型半胱氨酸 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]