血清同型半胱氨酸水平对急性冠脉综合征患者的影响及其与冠状动脉病变支数、冠状动脉病变严重程度的相关性研究  

Impact of Serum Homocysteine Level on Patients with Acute Coronary Syndrome and Its Correlations with Number of Stenosed Coronary Arteries and SYNTAX Score

作　　者：韩玉龙[1] 梁立龙[1] 许明生[1] 张建[1] 杨林飞[1] 

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)心血管内科,安徽省合肥市230011

出　　处：《实用心脑肺血管病杂志》2016年第11期20-24,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨血清同型半胱氨酸(Hcy)水平对急性冠脉综合征(ACS)患者的影响及其与冠状动脉病变支数、冠状动脉病变严重程度的相关性。方法选择2013—2015年安徽医科大学附属合肥医院收治的ACS患者84例,根据血清Hcy水平分为Hcy正常组(对照组,n=36)和Hcy升高组(研究组,n=48)。比较两组患者的一般资料〔年龄、性别、ACS分型、合并疾病(高血压、高脂血症、糖尿病)、既往史(冠心病家族史、吸烟史、心肌梗死病史、冠状动脉支架置入术史及冠状动脉旁路移植术史)〕、实验室检查指标〔随机血糖、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、空腹血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、超敏C反应蛋白(hs-CRP)〕、冠状动脉病变支数及SYNTAX评分,血清Hcy水平与冠状动脉病变支数、SYNTAX评分的相关性分析采用Spearman秩相关性分析。结果两组患者年龄、性别、高血压发生率及冠心病家族史、心肌梗死病史、冠状动脉支架置入术史阳性率比较,差异无统计学意义(P>0.05);研究组患者ACS分型差于对照组,高脂血症、糖尿病发生率及吸烟史阳性率高于对照组(P<0.05),两组患者中无一例有冠状动脉旁路移植术史。研究组患者随机血糖、c Tn I、CK-MB、空腹血糖、TC、LDL-C、TG、hs-CRP及SYNTAX评分高于对照组,冠状动脉病变支数多于对照组(P<0.05)。Spearman秩相关性分析结果显示,血清Hcy水平与ACS患者冠状动脉病变支数(rs=0.238,P<0.05)、SYNTAX评分呈正相关(rs=0.870,P<0.05)。结论 Hcy水平升高的ACS患者血糖、血脂水平更高,心功能损伤和冠状动脉病变程度更严重,且血清Hcy水平与冠状动脉病变支数、冠状动脉病变程度有关。Objective To investigate the impact of serum homocysteine level on patients with acute coronary syndrome and its correlations with number of stenosed coronary arteries and SYNTAX score. Methods A total of 84 patients with acute coronary syndrome were selected in Hefei Hospital Affiliated to Anhui Medical University from 2013 to 2015, and they were divided into control group （with normal serum homocysteine level, n = 36） and study group （with elevated serum homocysteine level, n = 48） according to the serum homocysteine level. General information [ including age, gender, types of acute coronary syndrome, complications （such as hypertension, hyperlipidaemia and diabetes）, past medical history （ such as family history of coronary heart disease, smoking history, history of myocardial infarction, coronary stent implantation history and coronary artery bypass grafting history） ], laboratory examination results （ including random plasma glucose （ RPG）, cTnI, CK-MB, fasting plasma glucose （FPG）, TC, LDL-C, TG and hs-CRP）, number of stenosed coronary arteries and SYNTAX score were compared between the two groups, correlations between serum homocysteine level and number of stenosed coronary arteries, and SYNTAX score were analyzed by Spearman correlation analysis. Results No statistically significant differences of age, gentler, incidence of hypertension, positive rate of family history of coronary heart disease, history of myocardial infarction or coronary stent implantation history was found between the two groups （ P 〉0. 05 ） ; the proportion of STEM1, ineidence of hyperlipidaemia and diabetes, and positive rate of smoking history of study group were statistically significantly higher than those of control group （P〈0. 05）; no one of the two groups received coronary artery bypass grafting. RPG, cTnI, CK-MB, FPG, TC, LDL-C, TG, hs-CRP and SYNTAX score of study group were statistically significantly higher than those of control group, and number of stenosed coronary arteries of study

关 键 词：急性冠脉综合征 半胱氨酸 冠状动脉疾病 SYNTAX评分 

分 类 号：R542.2[医药卫生—心血管疾病]