同型半胱氨酸、尿酸与冠状动脉斑块性质的关系  

Correlation Between the Level of Homocysteine and Uric Acid and Properties of Coronary Plaque

作　　者：孔超敏 宋衍秋[3] 赵福梅[3] 刘婷[3] 梁硕[3] 张洪[3] 丛洪良[3] KONG Chao-min;SONG Yan-qiu;ZHAO Fu-mei;LILT Ting;LIANG Shuo;ZHANG Hong;CONG Hong-liang(Graduate School of Tianjin Medical University,Tianjin(300070),China)

机构地区：[1]天津医科大学研究生院,天津市300070 [2]河北省人民医院 [3]天津市胸科医院

出　　处：《中国循环杂志》2018年第12期1193-1196,共4页Chinese Circulation Journal

摘　　要：目的:应用冠状动脉(冠脉)双源计算机断层摄影术(CT)血管造影(DSCTA)评价冠脉斑块的性质,分析血同型半胱氨酸(Hcy)、血尿酸水平与冠脉斑块性质的关系。方法:连续筛选2017-02至2017-06,因"胸闷、胸痛"就诊于天津市胸科医院疑诊冠心病并行DSCTA的患者150例,根据造影结果分为对照组(冠脉无斑块)、稳定斑块组(斑块以钙化为主)、高危斑块组[正性重构(重构指数>1.1)、低CT值(<30 HU)和餐巾环征三项都具备的斑块],每组各50例。血Hcy用循环酶法测定,血尿酸用酶比色法测定。比较3组间血Hcy、血尿酸的水平。结果:对照组、稳定斑块组、高危斑块组的血Hcy、血尿酸水平有递增趋势。两两组间比较血Hcy水平差异均具有统计学意义(P均<0.05),高危斑块组和稳定斑块组血尿酸水平均较对照组高(P均<0.05),但高危斑块组和稳定斑块组血尿酸水平无明显差异。有序多分类Logistic回归提示血Hcy与冠脉斑块的稳定性有显著性关联(OR=1.126,95%CI:1.021～1.244,P=0.017)。结论:在冠脉斑块患者中血Hcy水平与冠脉斑块的稳定性相关联。Objectives:To analyze the relationship between the level of homocysteine(Hcy) and uric acid(UA) and properties of coronary plaque detected by dual-source computed tomography angiography(DSCTA).Methods: 150 patients underwent DSCTA in Tianjin Chest Hospital from 2017-02 to 2017-06 due to suspected coronary artery disease were divided into control group(no plaque, n=50), stable plaque group(calcified plaque, n=50) and high risk plaque group(positive remodeling index>1.1, CT value< 30 Hounsfield unit and napkin-ring sign, n=50). The Hcy level was measured by cycling enzymatic method, and the UA level was measured by enzymatic colorimetry. Results: Levels of Hcy increased significantly in stable plaque and high risk plaque group than in control group and in high risk plaque group than in stable plaque group(P<0.05). The UA level also increased significantly in stable plaque and high risk plaque group than in control group(P<0.05). Ordinal regression analysis revealed that Hcy was a determinant of coronary artery plaque stability(OR=1.126, 95%CI: 1.021-1.244, P<0.05).Conclusions: Our results show that Hcy level in patients with coronary plaques is associated with coronary plaque instability.

关 键 词：同型半胱氨酸 尿酸 高危斑块 双源计算机断层摄影术血管造影 

分 类 号：R541.4[医药卫生—心血管疾病]