文章摘要
沈治利,李芝峰.血浆同型半胱氨酸与冠脉狭窄程度及病变支数的相关性研究[J].安徽医药,2020,24(2):316-319.
血浆同型半胱氨酸与冠脉狭窄程度及病变支数的相关性研究
Correlation between plasma homocysteine and severity of coronary artery stenosis and number of lesions branch
  
DOI:10.3969/j.issn.1009?6469.2020.02.026
中文关键词: 冠心病  冠状动脉狭窄  胆固醇  脂蛋白类, LDL  半胱氨酸  相关性 单支,
英文关键词: Coronary disease  Coronary stenosis  Cholesterol  Lipoproteins,LDL  Homocysteine  Correlation analysis
基金项目:
作者单位E-mail
沈治利 重庆医科大学附属永川医院心内科重庆402160  
李芝峰 重庆医科大学附属永川医院心内科重庆402160 lzf56888@163.com 
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中文摘要:
      目的探讨血浆同型半胱氨酸( Hcy)与冠脉狭窄程度及病变支数的相关性。方法回顾性纳入 2018年 1月至 2018年 9月重庆医科大学附属永川医院已行冠状动脉造影且结果为阳性的冠脉狭窄病人 103例,根据血浆 Hcy水平将其分为高同型半胱氨酸组( HHcy,Hcy≥10 μmol/L)71例和正常同型半胱氨酸组( NHcy,Hcy<10 μmol/L)32例,所有纳入病人均完善血浆同型半胱氨酸、尿酸以及血脂检测,采用冠脉 Gensini评分评估冠脉狭窄程度。结果 HHcy组的平均收缩压[(140±20)mmHg比(136±19)mmHg,P=0.381)]、平均舒张压[(84±13)mmHg比( 83±13)mmHg,P=0.752)]、尿酸[(413.0±130.6)μmol/L比( 346.0± 97.8)μmol/L,P=0.012)]、总胆固醇[(4.4±1.0)mmol/L比( 4.1±1.1)mmol/L,P=0.216)]、总三酰甘油[(1.6±0.9)mmol/L比( 1.5± 0.7)mmol/L,P=0.741)]及低密度脂蛋白胆固醇水平[(2.5±0.8)mmol/L比( 2.3±0.9)mmol/L,P=0.129)]均高于 NHcy组,冠脉 Gensini评分与 Hcy及低密度脂蛋白胆固醇水平呈正相关( r=0.2,0.2;p=0.012,0.012)Hcy水平能显著影响冠脉 Gensini评分,且 Hcy水平越高,冠脉 Gensini评分越高(相关系数= 0.804,P=0.015); NHcy组冠脉病变占 50%,双支病变占 40.6%,三支病变占 9.4%,HHcy组中单支病变占 25.4%,双支病变占 33.8%,三支病变占 40.8%(χ2=11.38,P=0.03)。结论血浆 Hcy水平及低密度脂蛋白胆固醇与冠脉狭窄程度呈正相关,但相关性较弱,高水平的同型半胱氨酸是冠脉严重病变的独立危险因素,且会增加冠脉三支病变的发生率。
英文摘要:
      Objective To investigate the correlation between plasma homocysteine(Hcy)and coronary stenosis and the number of lesions branch.Methods 103 patients who undergone coronary angiography with positive results in Yongchuan Hospital Affiliatedto Medical University of Chongqing from Jan. 2018 to Sep. 2018 were retrospectively divided into high homocysteine group(HHcy, Hcy<10 μmol/L,n=71)and normal homocysteine group(NHcy,Hcy<10 μmol/L,n=32)according to the level of plasma Hcy. All patients underwent plasma Hcy,uric acid and blood lipids.The coronary Gensini score was used to assess the degree of coro? nary stenosis.Results Compared with NHcy group,the mean systolic blood pressure[( 140±20)mmHg vs.(136±19)mmHg,P= 0.381)],mean diastostolic blood pressure[(84±13)mmHg vs.(83±13)mmHg,P=0.752),serum uric acid(413.0±130.6)μmol/L vs.(346.0±97.8)μmol/L,P=0.012)] total cholesterol[( 4.4±1.0)mmol/L vs.(4.1±1.1)mmol/L,P=0.216)],triglyceride[( 1.6±0.9) mmol/L vs.(1.5±0.7)mmol/L,P=0.741)] and low density lipoprotein cholesterol levels[( 2.5±0.8)mmol/L vs.(2.3±0.9)mmol/L, P=0.129)were higher in HHcy group.Coronary Gensini score was positively correlated with Hcy and low density lipoprotein cho?lesterol levels(r=0.2,0.2;P=0.012,0.012).Hcy level can significantly affect the coronary Gensini score,and the higher the Hcy level,the higher the coronary Gensini score(β=0.804,P=0.015).In NHcy group,50% were single vessel lesions,40.6% were dou? ble vessel lesions,and 9.4% were triple vessel lesions;In NHcy group,25.4% were single vessel lesions,33.8% were double vessel lesions,and 40.8% were triple vessel lesions(χ2=11.38,P=0.03).Conclusion The level of plasma Hcy and low density lipopro? tein cholesterol are positively correlated with the degree of coronary stenosis,but the correlation is weak.High levels of Hcy is an in? dependent risk factor for severe coronary artery disease,and increase the incidence of triple vessel lesions of coronary artery.
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