同型半胱氨酸引起血小板聚集率升高对心血管疾病的影响  

Effect on the platelet aggregation elevation induced by homocysteine on cardiovascular diseases

作　　者：孔繁亮[1] 陈小艳[1] 陈缙[1] 徐元杰[1] 赵强[1] 吴同果[1] 

机构地区：[1]暨南大学医学院附属广州市红十字会医院心血管医学部,510220

出　　处：《广东医学》2016年第13期1948-1951,共4页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2012A030400037)

摘　　要：目的 研究高血压或（和）冠心病（CHD）患者血同型半胱氨酸（Hcy）升高是否引起血小板聚集率升高,以及对心血管疾病的影响。方法 回顾性分析338例高血压或（和）CHD患者的临床资料,分析Hcy与CHD、稳定性心绞痛（SA）、不稳定型心绞痛（UA）、急性心肌梗死（AMI）、心力衰竭（HF）、冠脉病变支数、再住院率以及血小板聚集率的相关性。结果 高Hcy患者CHD的发生率明显高于低Hcy患者（84.7%vs 67.3%,P〈0.001）,其中高Hcy患者UA、AMI和HF的发生率均较低Hcy患者显著升高（44.1%vs 27.4%,33.5%vs 21.4%,41.2%vs 18.5%,P均〈0.05）;高Hcy的CHD患者三支病变较低Hcy患者显著升高（53.5%vs 32.7%,P=0.001）,同样,其再住院率也显著升高（42.4%vs 19.5%,P〈0.001）。高Hcy患者AA 0（0~4）Ω高于低Hcy患者0（0~1）Ω,差异有统计学意义（P=0.003）。结论 Hcy升高导致血小板聚集率升高,最终使心血管事件发生率升高,甚至预后不良。Objective To investigate the correlation between elevated homocystein（Hcy） and the platelet aggre- gation, and its influence on cardiovascular diseases. Methods This retrospective study was conducted in 338 patients with hypertension and/or coronary heart disease （ CHD ）. The correlations between Hey concentration and CHD, stable angina （SA）, unstable angina（UA）, acute myocardial infarction （AMI） , heart failure （HF）, the severity of coronary artery lesion, the re -hospitalization rate or platelet aggregation were analyzed. Results The frequencies of CHD, UA, AMI and HF were 84. 7% , 44. 1% , 33.5% and 41.2% , respectively, in high Hey group （ Hey~〉 13 retool/L） versus 67.3% , 27. 4% , 21.4% and 18. 5% , respectively, in low Hcy group （Hey 〈 13 retool/L, P 〈0. 05）. In addition, the frequency of three - vessel lesions were 53.5% and 32. 7% in high Hcy group and low Hcy group, respectively （ P = 0. 001 ） , and the re - hospitalization rateswere 42.4% in high Hcy group and 19. 5% in group low Hcy group （ P 〈 0. 001 ）. The AA in high Hcy group was significantlyhigher than that in low Hcy group （2. 66±4. 06 vs 1.20±2. 74, P 〈 0. 001 ）. Conclusion As Hcy concentration elevating, the platelet aggregation is rising, which increases the morbidity of CHD and adverse prognosis.

关 键 词：同型半胱氨酸 血小板聚集率 心血管疾病 

分 类 号：R587.1[医药卫生—内分泌]