同型半胱氨酸对2型糖尿病合并冠心病患者冠状动脉病变的影响  

The effects of serum homocysteine on coronary lesions degree in type 2 diabetic patients with coronary heart disease

作　　者：徐三彬[1] 张华[1] 郑建普[1] 沈峻[1] 金惠根[1] 刘宗军[1] 

机构地区：[1]上海市普陀区中心医院上海中医药大学附属普陀医院心内科,上海200062

出　　处：《临床心血管病杂志》2016年第5期468-471,共4页Journal of Clinical Cardiology

基　　金：上海市医学重点学科(No:ZK2015A17)

摘　　要：目的:探讨2型糖尿病中血浆同型半胱氨酸(Hcy)水平对冠状动脉(冠脉)病变的影响。方法:将150例患者分为正常对照组(20例)、糖尿病不伴冠心病组(28例)、冠心病不伴糖尿病组(52例)及糖尿病合并冠心病组(50例),再根据冠脉造影将冠脉病变分为0、1、2和3支病变,采用单因素筛选和多因素分析得出糖尿病患者血浆Hcy水平与冠脉病变的关系。结果:冠心病伴或不伴糖尿病组血浆Hcy水平与正常对照组相比明显升高(P<0.01);糖尿病合并冠心病组血浆Hcy水平较冠心病不伴糖尿病组及糖尿病不伴冠心病组均显著增高(均P<0.05);糖尿病不伴冠心病组血浆Hcy水平与正常对照组比较,差异无统计学意义。多因素分析结果表明,Hcy是影响糖尿病合并冠心病患者冠脉病变程度的主要独立危险因素,而对非糖尿病患者冠脉病变程度影响不明显。另外,亚组分析显示糖尿病合并冠心病患者血浆Hcy越高,冠脉病变程度越重。结论:Hcy与糖尿病合并冠心病患者的冠脉病变程度具有明显相关性。Objective：To explore the effect of the serum homocysteine（Hcy）on coronary lesions in type 2diabetic patients with coronary heart disease.Method：A total of 150 patients were divided into four groups：control without diabetes and coronary artery disease（CAD）（n=20）,CAD without diabetes（n=28）,diabetes without CAD（n=52）;CAD and diabetes（n=50）.Subjects were graded as nonstenotic,single-vessel stenotic,two-stenotic,and three-stenotic lesions based on the number of stenotic coronary artery.Result：The plasma Hcy level in patients with both CAD and diabetes and patients with CAD alone were higher than that without diabetes and CAD（P〈0.05）.The plasma Hcy level was significantly higher in patients with CAD and diabetes than in patients with either diabetes or CAD（P〈0.05）.Multiple-factor and subgroup analysis showed that the plasma Hcy level was strongly correlated with the number of stenotic coronary arteries in the diabete patients（P〈0.05）.Conclusion：The serum Hcy level is obviously correlated with the degree of coronary lesions in type 2diabetic patients with coronary heart disease.

关 键 词：同型半胱氨酸 冠心病 2型糖尿病 冠脉病变程度 

分 类 号：R541[医药卫生—心血管疾病]