血浆同型半胱氨酸水平与急性心肌梗死冠状动脉病变程度的相关性研究  

The correlation between plasma Hcy levels and the severity of coronary artery lesion in patients with acute myocardial infarction

作　　者：李富利[1] 赵艳军[1] 张爱文[1] 于健[1] 巨名飞[1] 张艳敏[1] LI Fuli;ZHAO Yanjun;ZHANG Aiwen(Affiliated Hospital of Chengde Medical College,Hebei,Chengde 067000,China)

机构地区：[1]承德医学院附属医院

出　　处：《河北医药》2019年第16期2459-2461,2465,共4页Hebei Medical Journal

摘　　要：目的检测急性心肌梗死(AMI)患者血浆同型半胱氨酸(Hcy)的水平,观察高Hcy与冠状动脉病变的相关性,以探讨高Hcy在心血管疾病中的作用。方法选择2017年1月至2018年12月于发病12h内在急诊就诊收入院的急性心肌梗死患者80例作为观察组,同时选取80例冠状动脉造影或冠状动脉CT正常者作为对照组。检测2组患者血浆Hcy、血糖、血脂水平。急性心肌梗死组通过冠状动脉造影确认。AMI组患者记录冠状动脉病变支数和冠状动脉狭窄程度(IRA)。结果AMI组血浆Hcy水平(24.70±5.28)μmol/L>对照组血浆Hcy水平(9.32±2.26)μmol/L,差异有统计学意义(P<0.01);AMI冠状动脉各支病变组血浆Hcy水平结果(三支病变(40.69±3.15)μmol/L>双支病变(30.12±3.21)μmol/L>单支病变(20.84±2.38)μmol/L,差异有统计学意义(P<0.01);AMI组中有43例冠脉狭窄程度为100%(完全闭塞),血浆Hcy水平为(40.57±4.06)μmol/L,37例冠脉狭窄程度95%~99%(非完全闭塞),血浆Hcy水平为(23.39±5.67)μmol/L,与冠脉狭窄程度95%~99%者相比较,冠脉狭窄程度100%者,血浆Hcy水平升高,差异有统计学意义(P<0.01)。结论AMI患者血浆Hcy水平升高;冠脉病变支数、狭窄程度与其正相关。Objective To observe the plasma levels of homocysteine(Hcy)in patients with acute myocardial infarction(AMI),and to investigate the correlation between plasma Hcy levels and the severity of coronary artery lesion,and to explore the role of homocysteine in cardiovascular diseases.Methods A total of 80 patients with AMI who were admitted and treated in our hospital from January 2017 to December 2018 were enrolled as AMI group,at the same time,the other 80 patients with normal coronary angiography or coronary CT were enrolled as control group.The levels of plasma homocysteine,blood glucose and blood lipid were detected in both groups.The patients with AMI were confirmed by coronary angiography.Moreover the number of coronary artery lesions and the degree of coronary artery stenosis(IRA)were recorded in patients with AMI.Results The plasma Hcy levels in AMI group were(24.70±5.28)μmol/L,which were significantly higher than those[(9.32±2.26)μmol/L]in control group(P<0.01).The plasma Hcy levels in AMI patients with coronary artery lesions(triple-vessel lesions)were(40.69±3.15)μmol/L,which were significantly higher than those[(30.12±3.21)μmol/L]of double-vessel lesions,which were significantly higher than those[(20.84±2.38)μmol/L]of single-vessel lesions(P<0.01).In AMI group,the degree of coronary artery stenosis was 100%(complete occlusion)in 43 cases,with plasma Hcy levels being(40.57±4.06)μmol/L,and the degree of coronary artery stenosis was 95%~99%(incomplete occlusion)in 37 cases,with the plasma Hcy levels were(30.39±5.67)μmol/L.As compared with the patients with the degree of coronary artery stenosis being 95%~99%,the plasma Hcy levels were significantly increased in the patients with the degree of coronary artery stenosis being 100%(P<0.01).Conclusion The plasma Hcy levels are increased in patients with AMI,moreover,the number of coronary artery lesions and stenosis degree are positively correlated with plasma Hcy levels.

关 键 词：同型半胱氨酸 急性心肌梗死 冠状动脉造影 冠状动脉病变 

分 类 号：R542.22[医药卫生—心血管疾病]