老年冠心病患者冠脉病变和血浆同型半胱氨酸水平的关系  

Relationship between Plasma Homocysteine Level and Severity of Coronary Atherosderosis in Elderly Patients with Coronary Heart Disease

作　　者：刘师节 杨莉[1] 何燕[1] 杨文慧[1] 孙桂芳[1] 董阳[1] 

机构地区：[1]昆明医科大学附属延安医院老年病科,云南昆明650051

出　　处：《昆明医科大学学报》2015年第10期28-31,共4页Journal of Kunming Medical University

基　　金：云南省社会发展科技计划基金资助项目(2010ZC199)

摘　　要：目的探讨血浆同型半胱氨酸(homocysteine,Hcy)水平与冠状动脉病变程度及斑块稳定性的关系.方法依据64层双源CT(dual-source computed tomography 64-DSCT)结果将120例冠心病患者以CT值不同分为易损斑块组、混合斑块组和硬斑块组,每组40例,同期选择冠状动脉CT正常的老年患者40例作为对照组.再根据冠脉病变情况将冠心病患者分为多支病变组、双支病变组、单支病变组.检查所有患者血浆Hcy水平,分析Hcy与斑块稳定性和冠脉病变支数的关系.结果易损斑块组Hcy水平(19.32±4.76)μmol/L比混合斑块组(14.15±3.89)μmol/L、硬斑块组(14.33±2.91)μmol/L和对照组(9.32±3.84)μmol/L高,差异有统计学意义,P<0.05.Hcy水平在冠脉双支病变组(15.38±3.45)μmol/L、多支病变组(16.12±4.12)μmol/L均比单支病变组(10.45±2.76)μmol/L高,差异有统计学意义,P<0.05.结论 Hcy水平可反映冠脉病变程度的严重性和斑块的稳定性.Objective To explore relationship between plasma homocysteine（Hcy） level and severity of coronary atherosderosis in the elderly.Methods According to the CT scale, these patients who underwent64- slice spiral CT coronary angiography（64- DSCT） were divided into four groups： normal group（40 cases）,vulnerable plaque group（40 cases）,mix plaque group（40 cases） and hard plaque group（40 cases）.According to the level of coronary artery lesions, these patients with coronary heart disease were divided into multivessel lesions,the double branch lesion group and single lesion group.Plasma Hcy were measured in all patients.Then we analysed the realationship between the level of Hcy and plaque stability and coronary artery lesion respectively.Results The level of Hcy in vulnerable plaque group was（19.32±4.76） μmol/l,which was higher than mix plaque group,hard plaque group and normal group（P〈0.05）.The level of Hcy in vulnerable plaque group was（19.32±4.76） μmol/l,which was higher than mix plaque group, hard plaque group and normal group（P〈0.05）.The level of Hcy in coronary lesions of two branches group was（15.38±3.45） μmol/l and three branches group was（16.12±4.12） μmol/l which were higher than the single branch group,the difference was statistically significant（P〈0.05）.Conclusion The level of Hcy can reflect the severity of atherosclerosis and the stability of plaque.

关 键 词：冠状动脉疾病 同型半胱氨酸 体层摄影技术 螺旋CT 

分 类 号：R541.4[医药卫生—心血管疾病]