血浆S-腺苷同型半胱氨酸水平检测与冠状动脉狭窄程度的关系研究  

Study on the Relationship between Plasma S-adenosine Homocysteine Levels and Coronary Artery Stenosis

作　　者：李毓龙 朱紫衣 付霞 余剑波 钟原胜 LI Yu-long;ZHU Zi-yi;FU Xia;YU Jian-bo;ZHONG Yuan-sheng(Department of Laboratory Medicine,Jianyang Municipal People’s Hospital,Sichuan Jianyang 641400,China)

机构地区：[1]简阳市人民医院实验医学科,四川简阳641400

出　　处：《现代检验医学杂志》2021年第3期92-96,共5页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血浆中S-腺苷同型半胱氨酸(S-adenosine homocysteine,SAH)与冠状动脉狭窄程度的关系。方法选取2018年1月~2019年12月于简阳市人民医院就诊的疑似冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CHD)患者663例作为研究对象,根据冠状动脉造影检查结果,将患者分为CHD组(经冠状动脉造影确诊)(n=386)和对照组(n=277)。采集空腹静脉血标本检测血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、脂蛋白(a)[Lipoprotein a,LP(a)]、同型半胱氨酸(homocysteine,Hcy)和SAH水平,采用Gensini积分法评估CHD组冠状动脉狭窄程度,并分析上述指标与其相关性。结果CHD组患者LDL-C,LP(a),Hcy和SAH水平高于对照组,而HDL-C水平低于对照组,差异均具有统计学意义(t=3.71~14.70,均P<0.05);CHD组患者冠状动脉狭窄程度Genisini积分与患者LDL-C,LP(a),Hcy和SAH呈正相关(r=0.408~0.635,均P<0.05),而与HDL-C呈负相关(r=-0.404,P<0.05)。结论CHD患者血浆SAH水平明显升高,与传统血清学指标相比,血浆SAH浓度水平与冠状动脉病变程度的相关性最高,血浆SAH可能是一种新的生物学标志物用于CHD的临床诊断,在临床诊疗过程中可将血浆SAH用于评估冠脉病变情况,对于CHD的预防和诊疗具有重要意义。Objective To Discuss the relationship S-adenosine homocysteine(SAH)in plasma and coronary artery stenosis.Methods Selected 663 patients with suspected coronary atherosclerotic heart disease(CHD)who visited Jianyang Municipal People’s Hospital from January 2018 to December 2019 as the subjects.According to the results of coronary angiography,the patients were divided into CHD groups(confirmed by the coronary angiography)(n=386)and control groups(n=277).Serum levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a)[LP(a)],homocysteine(Hcy)and plasma SAH were measured.The Gensini integral method was used to evaluate the degree of coronary artery stenosis in CHD group.Analyzed the correlation between the above indicators and it.Results The LDL-C,LP(a),Hcy and SAH levels in CHD group were higher than those in the control group and the HDL-C level was lower than those in the control group,the difference were statistically significaunt(t=3.71~14.70,all P<0.05).The scores of coronary artery stenosis in the CHD group were positively correlated with LDL-C,LP(a),Hcy,SAH(r=0.408~0.635,all P<0.05),and was negatively correlated with HDL-C(r=-0.404,P<0.05).Conclusion The plasma SAH level of CHD patients was significantly increased.Compared with traditional serological indicators,the level of plasma SAH had the highest correlation with the degree of coronary artery disease.SAH may be a new biomarker for CHD clinical diagnosis.SAH can be used to evaluate coronary artery disease in clinical diagnosis and treatment,which is important for the prevention and diagnosis of coronary artery disease.

关 键 词：S-腺苷同型半胱氨酸 冠状动脉粥样硬化性心脏病 GENSINI评分 相关性 

分 类 号：R543.3[医药卫生—心血管疾病] R446.112[医药卫生—内科学]