同型半胱氨酸代谢异常与冠心病的关系  

The Association of the Abnormal Homocysteine Metabolism and Coronary Heart Disease

作　　者：秦勤[1,2] 赵炳让[1,2] 崔让庄[1,2] 毛用敏[1,2] 耿婕[1,2] 屈大展[1,2] 陈倩[1,2] 寇璐[1,2] 

机构地区：[1]天津市胸科医院心内三科,300051 [2]天津市心血管研究所,300051

出　　处：《中国分子心脏病学杂志》2002年第4期16-19,共4页Molecular Cardiology of China

摘　　要：目的:探讨同型半胱氨酸代谢异常与冠心病的关系。方法:选择245例健康对照者和入住我院冠心病房的439例经冠状动脉造影证实为冠心病者作为研究对象,监测其血浆同型半胱氨酸(Hcy)、叶酸和VitB_(12),水平,分析亚甲基四氢叶酸还原酶(MTHFR)基因多态性,并根据冠状动脉造影结果,分成单支、双支和三支病变组,分析病变支数与MTHFR基因多态性的关系。结果:冠心病患者血浆Hcy水平(17.61±11.62)显著高于对照组(12.92±8.23)(p<0.001),叶酸和VitB_(12)水平低于对照组(p<0.05)。冠心病组TT基因型明显高于对照组(p<0.05),冠心病组中三支血管病变组的TT基因频率比单支和双支血管病变组高(p<0.005),TT型纯合子的血浆Hcy含量与CC型纯合子和CT杂合子比较具统计学差异(p<0.001),而叶酸和VitB_(12)含量低于后两者(p<0.05)。结论:血浆Hcy含量和MTHFR基因突变相关,其TT纯合子血浆Hcy水平最高,而在三支血管病变组的TT基因频率最高,提示MTHFR基因突变可导致Hcy水平升高,是冠心病的危险因素。Objective： To study the association of homocysteine metabolism and coronary heart disease . Method： 245 controls and 439 patients were recruited and coronary angiography was performed on all of tile patients and control - The levels of hcy , folate and VitB12 were determined with HPLC and radioimmunoassay. Genetic polymorphism of methylenetetrahydrofolate reductase （MTHFR）, CHD cases were divided into single-vessel , double-vessel and triple-vessel group according to angiography. We examined the precise relation of genetic polymorphism of MTHFR to the number of coronary artery with stenosis . Result： Mean plasma homocysteine level was significantly higher in patients with coronary heart disease than that in controls （p 〈 0.001）. The levels of folate and VitB12 were lower in CHD patients than in controls （p 〈 0.05）. The frequency of the TT genotype was significantly higher in CHD patients than in controls （p 〈 0.05 ）. Especially the frequency of the TT genotype was significantly higher in patients with triple-vessel than in patients with single- or double-vessel group （p 〈 0.005）. The plasma levels of homocysteine had evident difference in TT and CC, CT genotype （p 〈 0.001 ）. The levels of folate and VitB12 in TT were lower than in CC, CT genotype （p 〈 0.05 ）. Conclusion： The plasma levels of homocysteine associated with the mutation of MTHFR . TT genotype （mutation type ）had the highest levels of homocysteine. The frequency of TT genotype was highest in patients with triple-vessel. The study showed the mutation of MTHFR, which leaded to the elevation of Hcy level was a risk factor of CHD.

关 键 词：同型半胱氨酸 亚甲基四氢叶酸还原酶基因变异 冠状动脉造影术 

分 类 号：R541.4[医药卫生—心血管疾病]