血清同型半胱氨酸水平与冠心病严重程度相关性的探讨  

CORRELATION BETWEEN SERUM HOMOCYSTEINE LEVEL AND SEVERITY OF CORONARY ARTERY DISEASE

作　　者：李秀昌[1] 胡燕燕[1] 张运[1] 李继福[1] 李华[1] 傅善基[2] 陈玉国[3] 

机构地区：[1]山东大学齐鲁医院心内科 [2]山东大学齐鲁医院中心实验室 [3]山东大学齐鲁医院急症科

出　　处：《山东医科大学学报》2001年第4期301-303,共3页Acta Academiae Medicinae Shandong

基　　金：山东省科委资助课题 ( 981 2 1 65 1 0 )

摘　　要：目的 :探讨血清同型半胱氨酸水平与冠心病严重程度的关系。方法 :研究对象 194例 ,采用自动生化分析仪测定血脂、血糖、尿素氮、肌酐等。应用高效液相色谱法测定血清同型半胱氨酸浓度。选择性冠状动脉造影的 13 2例计算冠脉病变支数和Gensini冠脉病变积分。采用SAS软件分析。结果 :急性心肌梗死组血清同型半胱氨酸水平显著高于其它各组 ,正常对照组则明显低于冠心病组 ;而心绞痛组和陈旧性心肌梗死组差异无显著性。血清同型半胱氨酸水平与冠脉病变积分呈正相关 (r =0 .76,P <0 0 0 1) ,多元逐步回归分析剔除了其它常见影响因素后这种相关性仍然存在。结论 :血清同型半胱氨酸水平升高是冠心病的独立危险因素 ;不同类型的冠心病患者血清同型半胱氨酸水平差异有显著性 ,血清同型半胱氨酸水平升高是促使急性心肌梗死发生的可能因素 ;随着血清同型半胱氨酸水平升高 ,罹患冠心病危险性增加。Objective:To study the relationship between serum homocysteine level and severity of coronary artery disease.Methods:Serum homocyteine concentration was measured by high performance liquid chromatography(HPLC).Gensini coronary scoring system was used to calculate coronary artery score in cases undergoing selective coronary artery angiography( n=132) .The SAS system was applied to analyze the data.Results:Serum homocysteine level was significantly higher in AMI group than that of other groups,and significantly lower in control group than that of other groups,while there was no significant difference between OMI and AP group.A significantly positive correlation between coronary artery score and serum homocysteine level was found( r=0.76,P<0.001) .After being corrected for other common factors(age,sex,BMI,blood pressure and blood lipid,etc.)by multivariate stepwise regression analysis,this relationship also existed(Partial regression coefficient β=5.1, P<0.05). Conclusion:Mild elevation of serum homocyteine level is an independent risk factor.There is significant difference among four types of coronary artery disease in serum homocysteine level.Elevation of serum homocyteine was a possible promoting factor of AMI, and with the raising of serum homocyteine the risk for developing coronary artery disease increases significantly.

关 键 词：高半胱氨酸 冠状动脉疾病 高压液相色谱法 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]