急性冠脉综合征患者血清同型半胱氨酸水平测定的临床意义  

Clinical significance of measurement of serum homocysteine level in patients with acute coronary syndrome

作　　者：吕璘琳[1] 孙芹敏[1] 宋明慧[2] 孙国华[1] 

机构地区：[1]大连医科大学附属第一医院检验科,辽宁大连116011 [2]大连医科大学,辽宁大连116044

出　　处：《大连医科大学学报》2009年第6期707-709,共3页Journal of Dalian Medical University

摘　　要：[目的]测定急性冠脉综合征(ACS)患者血清同型半胱氨酸(Hcy)水平,探讨血清Hcy水平与ACS严重程度的关系。[方法]将108例ACS患者分为不稳定性心绞痛(UA)组51例和急性心肌梗塞(AMI)组57例,其中75例根据冠状动脉造影结果又分为冠脉病变一支、二支、三支及以上组。以50例健康体检者作为对照组。测定各组血清Hcy水平,并进行统计学分析。[结果]血清Hcy水平UA组(15.40±5.51)μmol/L、AMI组(20.39±6.43)μmol/L,与对照组(10.21±3.61)μmol/L比较差异有显著性意义(P<0.01),UA组与AMI组比较,差异有显著性意义(P<0.01)。通过单因素方差分析,冠脉病变一支组(12.63±5.20)μmol/L、二支组(15.40±2.11)μmol/L和三支及以上组(21.56±5.89)μmol/L之间血清Hcy水平比较差异有显著性意义(F=23.803,P<0.01),且随病变支数增加,血清Hcy水平逐渐升高,提示患者血清Hcy水平与冠状动脉受累支数具有正相关性。对照组和一支组(P<0.05)、一支组和二支组(P<0.05)、二支组和三支及以上冠脉病变组(P<0.01)之间Hcy水平比较差异均有显著性意义。[结论]ACS患者血清Hcy水平显著高于正常人群,并与冠状动脉受累支数及疾病严重程度有正相关性。测定血清Hcy水平可能对ACS的预防和治疗监测具有重要临床意义。[ Objective] To measure the level of serum homocysteine （Hcy） in patients with acute coronary syndromes （ACS） and to discuss the relationship between serum Hcy level and severity of ACS. [ Methods ] One hundred and eight ACS patients were divided into two groups ：51 cases of unstable angina （UA） and 57 cases of acute myocardial infarction （AMI）. Among them 75 ACS patients were divided into one - branch, two - branch and three - branch and above three - branch groups according to the number of affected coronary branches verified by coronary arteriongraphy. Fifty healthy individuals were chosen as normal control. Level of serum Hcy was measured in all groups. [ Results ] Level of serum Hcy in UA group （ 15.40±5.51 ）μmol/L and AMI group （ 20.39±6.43 ） μmol/L were significantly higher than that in normal control （10.21±3.61 ）μmol/L,P 〈 0.01. The difference was significant when UA group was compared with AMI group （P 〈 0.01 ）. Statistical results from one - factor analysis of variance showed the differences of serum Hcy levels among one - branch group （ 12.63±5.20 ）μmol/L, two - branch group （ 15.40±2.11 ） μmol/L and three - branch and above three - branch group （21.56±5.89）μmol/L were significant （F=23. 803,P 〈 0.01 ）. As the number of coronary artery involvement increased levels of serum Hcy rose up, that suggested a positive relationship between patient＇s serum Hcy level and the number of coronary artery involvement. The differences between control group and one - branch group, one - branch group and two - branch group, two - branch group and three - branch group were all significant （ P 〈 0.05 or P 〈 0.01 ）. [ Conclusions] Level of serum Hcy in ACS patients increases significantly if compared with normal control and presents positive relationship with the numbers of coronary artery involvement and severity of ACS. The measurement of serum Hcy level could play an important role in the prevention, treatment and monitoring for ACS.

关 键 词：冠状动脉疾病 急性冠脉综合征 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]