血清同型半胱氨酸水平与对氧磷酶1活性及颈动脉粥样硬化的关系  

Relationship among serum homocysteine level,paraoxonase 1 activity and carotid atherosclerosis

作　　者：张珊[1] 张亮[1] 丁洁颖[2] 陆寒英 王长谦[1] 陈启稚[1] ZHANG Shan ZHANG Liang DING Jie-ying LU Han-ying WANG Chang-qian CHEN Qi-zhi(Department of Cardi- ology, Affiliated Ninth People＇s Hospital of Medical College of Shanghai Jiaotong University, Shanghai, 200011)

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海市200011 [2]上海交通大学医学院附属第九人民医院检验科,上海市200011 [3]上海市黄浦区豫园街道社区卫生服务中心

出　　处：《心血管康复医学杂志》2017年第1期8-12,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：上海市卫生系统重要疾病联合攻关项目(2014ZYJB0501);上海申康医院发展中心慢性病综合防治项目(SHDC12012312)~~

摘　　要：目的:研究血清同型半胱氨酸(Hcy)水平、血清对氧磷酶1(PON1)活性和颈动脉粥样硬化的关系。方法:选择2012年-2014年上海某社区参加心血管疾病危险因素筛查的居民共179例,进行颈动脉超声检查,测定血清Hcy、PON1及其他生化指标。根据血清Hcy水平,研究对象被分为Hcy升高组(85例)和Hcy正常组(94例)。结果:Spearman相关分析显示血清Hcy水平与PON1活性呈显著负相关(r=-0.738,P=0.001)。与Hcy正常组比较,Hcy升高组年龄[(60.66±7.18)岁比(64.57±7.29)岁]、男性比例(27.66%比63.53%)、血肌酐[(69.62±12.76)μmol/L比(88.47±20.86)μmol/L]、血尿酸[(267.85±63.02)μmol/L比(307.51±76.07)μmol/L]、甘油三酯[(1.33±0.79)mmol/L比(1.76±1.70)mmol/L]和收缩压[(134.93±15.82)mmHg比(142.72±17.86)mmHg]显著升高,高密度脂蛋白胆固醇[HDL-C,(1.17±0.26)mmol/L比(1.06±0.27)mmol/L]和PON1[(288.58±73.80)kU/L比(187.81±16.31)kU/L]水平显著降低,P<0.05或<0.01。Hcy升高组颈动脉粥样硬化发生率显著高于Hcy正常组(64.7%比44.7%),P=0.001。多变量逐步Logistic回归分析显示,血肌酐和血清Hcy水平是影响血清PON1活性的独立危险因素[OR=1.055,1.139,P<0.01,<0.05];Hcy水平升高不是颈动脉粥样硬化的独立危险因素(OR=1.020,P=0.497)。结论:血清Hcy水平与血清PON1活性显著负相关,且二者与颈动脉粥样硬化的发生有关。Objective： To study relationship among serum homocysteine （Hcy） level, paraoxonase 1 （PON1） activity and carotid atherosclerosis. Methods： A total of 179 residents from a community of Shanghai, who participated in cardiovascular risk factor screening from 2012 to 2014, were selected. They received carotid ultrasonic examination and measurements of serum Hcy, PON1 and other biomarkers. According to serum Hcy level, subjects were divided into elevated Hcy group （n = 85） and normal Hcy group （n= 94）. Results： Spearman correlation analysis indicated that serum Hcy level was significant inversely correlated with PON1 activity （ r = - 0. 738, P = 0. 001）. Compared with normal Hcy group, there were significant rise in age [（60. 66± 7. 18） years vs. （64. 57 ± 7. 29） years], male proportion （27. 66% vs. 63.53%）, serum creatinine [（69.62 ± 12.76） μmol/L vs. （88. 47 ± 20.86） μmol/L], uric acid [（267. 85 ± 63.02） μmol/L vs. （307. 51 ± 76.07） μmol/L], triglyceride [（1.33 ± 0. 79） mmol/L vs. （1.76 ± 1.70） mmol/L]and systolic blood pressure [（134. 93 ± 15.82） mmHg vs. （142.72 ± 17. 86） mmHg], and significant reductions in levels of high density lipoprotein cholesterol [HDL-C, （1.17 ±0. 26） mmol/L vs. （1.06 ±0.27） mmol/L]and PON1 [（288. 58 ±73.80） kU/L vs. （187.81 ±16. 31） kU/]in el- evated Hcy group, P%0.05 or %0.01. Incidence rate of carotid atheroselerosis in elevated Hcy group was significantly higher than that of normal Hcy group （64. 7% vs. 44. 7%）, P = 0. 001. Multi-variate gradual Logistic regression analysis indicated that serum creatinine and Hcy levels were independent risk factors for serum PON1 activity（OR = 1. 055, 1. 139,P〈0.01, 〈0. 05） ; Hcy isn＇t an independent risk factor （OR = 1. 020, P = 0. 497） for carotid atherosclerosis. Conclusion： Serum Hcy level is significant inversely correlated with serum PON1 activity, and both of them are related to occurrence of carotid atherosclerosis.

关 键 词：高半胱氨酸 颈动脉疾病 危险因素 

分 类 号：R543.409[医药卫生—心血管疾病]