PCI术后冠心病患者血清同型半胱氨酸水平与病情预后的相关性分析  

The relationship analysis of serum homocysteine levels and prognosis of coronary artery disease patietns with PCI

作　　者：孟锐[1] 李新建 何水波[1] 靳维华[3] 

机构地区：[1]航天中心医院老年医学一科,北京100049 [2]菏泽市曹县人民医院心内科,山东菏泽274400 [3]航天中心医院心脏医学部,北京100049

出　　处：《临床和实验医学杂志》2017年第10期1039-1041,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探究经皮冠状动脉介入(PCI)术后冠心病患者血清同型半胱氨酸水平与病情预后的相关性。方法选择2015年1月至2017年1月期间航天中心医院接收的260例经PCI治疗后的冠心病(CHD)患者,根据Hcy水平分为观察组150例和对照组110例,均经冠脉造影检查和血清同型半胱氨酸(Hcy)水平检测,观察两组血清Hcy水平、冠状动脉靶血管数、3支病变比率、冠状动脉狭窄程度、置入支架数和SYNTAX积分。并于PCI术后随访1年,观察对比两组预后质量,同时分析Hcy水平对CHD严重程度及PCI预后质量的影响。结果观察组冠状动脉靶血管数、3支病变比率、冠状动脉狭窄程度、置入支架数、SYNTAX积分均明显高于对照组,差异有显著性(P<0.05)。经Spearman秩相关性分析,血清Hcy水平与冠状动脉病变支数(r_S=0.235,P<0.05)、冠状动脉狭窄程度(r_S=0.521,P<0.05)、SYNTAX积分(r_S=0.868,P<0.05)呈正相关关系。PCI术后随访1年,观察组主要不良心血管事件(MACE)发生率为16.7%,明显高于对照组的3.6%(P<0.05)。高Hcy是PCI术后MACE发生的主要独立风险因素之一(OR=1.025,P<0.05)。结论对CHD患者行血清Hcy检测,有助于冠心病的诊断和评估冠脉病变程度,且对评估PCI术后预后有重要的指导价值。Objective To explore the relationship analysis of serum homocysteine levels and prognosis of coronary artery disease patietns with PCI. Methods From January 2015 to January 2015 in Space Center Hospital 260 cases of CHD patients after PCI treatment were divided into observation group（ 150 cases） and control group（ 110 cases） according to the level of Hcy. Both groups received coronary angiography examination and serum Hcy level detection. Serum Hcy levels,target coronary artery vascular lesions,3 for ratio,the degree of coronary artery stenosis,stents placement and SYNTAX were observed,and after 1 year follow-up,the prognosis were observed and at the same time Hcy levels and quality of CHD severity and prognosis of PCI in the two groups were compared. Results Target vessel coronary artery lesions,3 for the proportion,the degree of coronary artery stenosis,stents placement,the SYNTAX score in observation group were higher than those of the control group（P〈0. 05）. The Spearman rank correlation analysis showed that serum Hcy levels and coronary artery lesion count（ r_S= 0. 235,P 0. 235）,the degree of coronary artery stenosis（ r_S= 0. 521,P〈0. 05）,the SYNTAX score（ r_S= 0. 868,P〈0. 05） were positively correlated. PCI postoperative follow-up of 1 year,the incidence of major adverse cardiac events（ MACE） in observation group was 16. 7%,which was bviously higher than that of control group 3. 6%（ P〈0. 05）. High Hcy was one of the main independent risk factors of MACE after PCI（ OR = 1. 025,P〈0. 05）. Conclusion Serum Hcy detection in patients with CHD can contribute to the diagnosis of coronary heart disease and assessment of the degree of coronary artery lesions,and guide for the assessment of PCI postoperative outcomes.

关 键 词：冠心病 经皮冠状动脉介入 同型半胱氨酸 预后 

分 类 号：R541.4[医药卫生—心血管疾病]