血浆同型半胱氨酸水平与冠心病患者中心动脉压及颈动脉狭窄程度的相关性研究  

Correlations between Plasma Homocysteine Level with Central Arterial Pressure and Degree of Carotid Stenosis in Patients with Coronary Artery Disease

作　　者：卢炜[1] 王鸿超[2] 杜超[1] 王立君[1] 

机构地区：[1]石家庄市第三医院心内一科,石家庄050000 [2]河北医科大学第二医院心内科,石家庄05000

出　　处：《解放军医药杂志》2016年第11期69-72,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：石家庄市科技计划项目(131461293)

摘　　要：目的探讨血浆同型半胱氨酸(Hcy)水平与冠心病患者的中心动脉压以及颈动脉狭窄程度之间的相关性。方法收集2013年9月—2015年9月于石家庄市第三医院诊治的疑似冠心病患者272例,均行冠状动脉造影,依据造影结果分为冠心病组160例及非冠心病组112例,依据血浆Hcy水平的不同分为正常、轻度、中度以及重度升高,根据颈动脉狭窄程度分为正常、轻度、中度、重度狭窄,同时行彩色多普勒超声检查颈动脉内膜厚度,有无斑块、狭窄,利用直径法计算狭窄率。记录两组年龄、性别、相关疾病病史、吸烟史、体重指数、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、尿酸、血浆Hcy水平以及中心动脉压。结果冠心病组血浆Hcy水平以及中心动脉压均高于非冠心病组(P<0.05)。冠心病组血浆Hcy水平与颈动脉狭窄程度、中心动脉收缩压、中心动脉脉压、中心动脉舒张压以及肱动脉收缩压呈明显正相关性(P<0.05、P<0.01),但是与肱动脉舒张压以及肱动脉脉压无明显相关性(P<0.05)。结论血浆Hcy水平较高的冠心病患者颈动脉狭窄程度较严重,中心动脉压较高,血浆Hcy水平是冠心病患者独立危险因素。Objective To investigate correlations between plasma homocysteine level with central arterial pressure and degree of carotid stenosis in patients with coronary artery disease（CAD）.Methods A total of 272 patients with suspected coronary heart disease during September 2013 and September 2015 underwent coronary angiography,and were divided into CAD group（n = 160） and non-CAD group（n = 112） according to angiography results,and were divided into normal,mild,moderate and severe increased carotid stenosis patients on the basis of different plasma homocysteine levels,and were divided into normal,mild,moderate and severe patients on the basis of degrees of carotid stenosis.At the same time,values of carotid intimal thickness（IMT）,plaque formation,stenosis,stenosis rate calculation method utilizing diameter method were detected by color Doppler ultrasonography.Age,gender,history of related diseases,smoking history,body mass index,fasting glucose,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,uric acid,plasma homocysteine levels and central artery press were recorded in two groups.Results Levels of plasma homocysteine and central arterial pressure in CAD group were higher than those in non-CAD group（P〈0.05）.Plasma Hcy levels in CAD patients showed significantly positive correlations with degree of carotid stenosis,central artery systolic blood pressure,central aortic pulse pressure,central aortic diastolic blood pressure and brachial artery systolic pressure（P〈0.05,P〈0.01）,but it had no significant linear correlation with brachial artery diastolic pressure and brachial artery pulse pressure（P〈0.05）.Conclusion CAD patients with higher plasma homocysteine levels have more severe degree of carotid stenosis and high level of central aortic pressure,and plasma homocysteine level is an independent risk factor of coronary artery disease.

关 键 词：冠心病 颈动脉狭窄 同型半胱氨酸 中心动脉压 

分 类 号：R541.4[医药卫生—心血管疾病] R543.4[医药卫生—内科学]