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目的探讨血浆同型半胱氨酸水平与冠状动脉病变程度的关系。方法对因胸痛而行冠状动脉造影检查的91例患者,根据冠状动脉造影结果,分为冠心病组(1支以上主要血管狭窄程度≥50%)和正常对照组。并对血管病变行Gensini积分。取空腹静脉血利用高效液相层析法测定血浆同型半胱氨酸的浓度。分别比较冠心病组与正常对照组,冠状动脉单支、双支、三支血管病变与正常对照组之间血浆同型半胱氨酸水平有无差异。结果冠心病组高同型半胱氨酸血症的检出率高于对照组(46.4%vs10%,X2=12.1,P<0.01)。不论是单支、双支、还是三支血管病变,其血浆同型半胱氨酸水平均高于正常对照组(P<0.01)。其中,三支血管病变组高于单支或双支病变组(P<0.05)。而单支、双支血管病变组之间差异无显著性(P>0.05)。血浆同型半胱氨酸水平随着Gensini积分的增加而升高。结论冠心病患者血浆同型半胱氨酸水平明显升高,高同型半胱氨酸血症的检出率高。随着冠状动脉病变支数增加,血浆同型半胱氨酸水平有逐步升高的趋势。血浆同型半胱氨酸水平与冠状动脉病变的严重程度一致。
Objective To investigate the relationship between the plasma homocysteine level and the severity of coronary artery disease. Methods 91 patients undergoing coronary angiography due to chest pain were divided into coronary heart disease group (≥1% major vascular stenosis≥50%) and normal control group according to coronary angiography. And Gensini points for vascular disease. Fasting venous blood plasma concentrations of homocysteine were determined by high performance liquid chromatography. The levels of plasma homocysteine in patients with coronary artery disease and normal control group were compared between coronary artery single vessel, double vessel, triple vessel disease and normal control group respectively. Results The detection rate of hyperhomocysteinemia in CHD group was higher than that in control group (46.4% vs10%, X2 = 12.1, P <0.01). The levels of plasma homocysteine in patients with single vessel, double vessel, or three vessel lesions were significantly higher than those in the normal control group (P <0.01). Among them, the three vessel disease group was higher than the single or double vessel disease group (P <0.05). However, there was no significant difference between single and double vessel disease group (P> 0.05). Plasma homocysteine levels increased with increasing Gensini score. Conclusion Plasma homocysteine level is significantly elevated in patients with coronary heart disease and high homocysteine is detected. With the increasing number of coronary lesions, plasma homocysteine levels gradually increased. Plasma homocysteine levels are consistent with the severity of coronary lesions.