冠心病患者发病48h内Hcy、vWF和组织因子促凝活性的变化及其与冠心病发病的关系  

Changes of Hcy,vWF and tissue factor procoagulant activity within 48h after onset in CHD patients and relationship between 3 indicators and coronary heart disease onset

作　　者：李德奎[1] 朱名安[1] 程多智[1] LI De-kui;ZHU Ming-an;CHENG Duo-zhi(Department of Laboratory, Taihe Hospital of Shiyan City, Shiyan, Hubei, 442000, Chi)

机构地区：[1]十堰市太和医院检验科,湖北十堰442000

出　　处：《心血管康复医学杂志》2018年第6期620-624,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察比较冠心病(CHD)患者和健康居民间同型半胱氨酸(Hcy)、血管假性血友病因子(vWF)和组织因子促凝活性(TF-PCA)的差异,及3项指标与冠心病发病的关系。方法:回顾性分析2013年4月-2015年12月期间,我院心内科收治的95例CHD急诊患者(CHD组)和同期行健康体检的95例健康居民(健康对照组)的临床资料。根据病情,CHD组被进一步分为稳定型心绞痛(SAP)组(33例)、不稳定型心绞痛(UAP)组(31例)和急性心肌梗死(AMI)组(31例)。测量比较各组以及CHD患者不同发病时间的Hcy、vWF和TFPCA,多因素Logistic回归分析冠心病类型的影响因素。结果:与健康对照组比较,CHD组Hcy [(9.22±3.45)μmol/L比(17.80±6.94)μmol/L]、vWF [(122.40±10.18)%比(160.13±10.48)%]和TF-PCA [(30.12±10.49)s比(69.45±8.26)s]均显著升高,P均=0.001。与SAP组比较,UAP组和AMI组的Hcy[(14.30±3.15)μmol/L比(20.50±4.97)μmol/L比(25.77±6.10)μmol/L]、vWF [(141.56±9.45)%比(168.23±11.29)%比(185.56±11.40)%]和TF-PCA [(45.13±11.52)s比(53.16±18.45)s比(64.49±11.59)s]均显著升高,且AMI组的显著高于UAP组的,P<0.05或<0.01。随着发病时间的推移,CHD患者Hcy、vWF和TF-PCA水平均显著降低,且均符合1h>12h>24h>48h,两两比较均有显著差异,P均=0.001。多因素Logistic回归分析显示,Hcy、vWF和TF-PCA是冠心病类型的独立危险因素(OR=2.586～5.058,P均=0.001)。结论:冠心病患者Hcy、vWF和TF-PCA水平均显著升高,病情越严重,水平越高;随着时间推移,其水平均显著下降。三项指标均为冠心病类型的独立危险因素。Objective:To observe and compare differences of levels of homocysteine(Hcy),von Willebrand factor(vWF)and tissue factor procoagulant activity(TF-PCA)between patients with coronary heart disease(CHD)and healthy residents,and analyze relationship between above3indicators and coronary heart disease onset.Methods:Clinical data of95CHD emergency patients(CHD group),who were treated in our department of cardiology from Apr2013to Dec2015,and95healthy residents(healthy control group)were retrospectively analyzed.According to state of an illness,CHD group was further divided into stable angina pectoris(SAP)group(n=33),unstable angina pectoris(UAP)group(n=31)and acute myocardial infarction(AMI)group(n=31).Levels of Hcy,vWF and TF-PCA were measured and compared among all groups and different time after onset in CHD patients.Multifactor Logistic regression analysis was used to analyze influencing factors of CHD types.Results:Compared with healthy control group,there were significant rise in levels of Hcy[(9.22±3.45)μmol/L vs.(17.80±6.94)μmol/L],vWF[(122.40±10.18)%vs.(160.13±10.48)%]and TF-PCA[(30.12±10.49)s vs.(69.45±8.26)s]in CHD group,P=0.001all.Compared with SAP group,there were significant rise in levels of Hcy[(14.30±3.15)μmol/L vs.(20.50±4.97)μmol/L vs.(25.77±6.10)μmol/L],vWF[(141.56±9.45)%vs.(168.23±11.29)%vs.(185.56±11.40)%]and TF-PCA[(45.13±11.52)s vs.(53.16±18.45)s vs.(64.49±11.59)s]in UAP group and AMI group,and those of AMI group were significantly higher than those of UAP group,P<0.05or<0.01.As onset time went by,there were significant reductions in levels of Hcy,vWF and TF-PCA in CHD patients,and all of them accorded with1h>12h>24h>48h,there existed significant difference between any two time points,P=0.001all.Multifactor Logistic regression analysis indicated that Hcy,vWF and TF-PCA were independent risk factors for CHD type(OR=2.586~5.058,P=0.001all).Conclusion:Levels of Hcy,vWF and TF-PCA significantly rise in CHD patients,the more severe disease is,the higher levels are.Along with time g

关 键 词：冠心病 高半胱氨酸 凝血致活酶 

分 类 号：R541.409[医药卫生—心血管疾病]