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目的通过多方面分析同型半胱氨酸(Hcy)与冠心病的关系,探讨Hcy预测冠心病的价值。方法选择2012年1月至2014年9月230例患者,经冠状动脉造影确诊的冠心病患者186例作为研究对象,同时将经冠状动脉造影排除冠心病患者44例作为对照。将186例患者分为急性冠脉综合征(ACS)组116例和稳定型心绞痛(SAP)组70例。根据冠脉病变程度分为单支病变组72例,双支病变组42例,多支病变组72例。根据Hcy高低分为高同型半胱氨酸(HHcy)组162例,非HHcy组68例。采用单因素方差分析、t检验、Pearson相关分析。结果 ACS组血浆Hcy明显高于SAP组及对照组,差异均有统计学意义(P<0.05)。冠状动脉单支病变组、多支病变组Hcy均明显高于对照组,差异有统计学意义(P<0.05)。单支病变组、双支病变组、多支病变组Gensini积分与Hcy均具有相关性(P<0.05)。HHcy组Gensini积分明显高于非HHcy组,差异有统计学意义(P<0.05)。结论 Hcy可能是冠心病的一个重要危险因素,Hcy水平可以预测急性冠脉事件及冠脉病变程度。
Objective To explore the value of Hcy in predicting coronary heart disease by analyzing the relationship between homocysteine (Hcy) and coronary heart disease in many aspects. Methods From January 2012 to September 2014, 230 patients with coronary heart disease diagnosed by coronary angiography were enrolled in the study. Totally 186 patients with coronary heart disease who underwent coronary angiography were selected as the control group. 186 patients were divided into acute coronary syndrome (ACS) group of 116 cases and stable angina pectoris (SAP) group of 70 cases. According to the extent of coronary artery lesions were divided into single-vessel disease group of 72 cases, double-vessel disease group of 42 cases, multiple-vessel disease group of 72 cases. 162 cases were divided into high homocysteine (HHcy) group and 68 cases non-HHcy group according to the level of Hcy. One-way analysis of variance, t test, Pearson correlation analysis. Results The plasma Hcy level in ACS group was significantly higher than that in SAP group and control group (P <0.05). Hcy in multi-vessel disease group and coronary artery single vessel disease group were significantly higher than those in control group (P <0.05). The Gensini score in single vessel disease group, double vessel disease group and multivessel disease group were all correlated with Hcy (P <0.05). The Gensini score of HHcy group was significantly higher than that of non-HHcy group (P <0.05). Conclusions Hcy may be an important risk factor for coronary heart disease. Hcy level can predict acute coronary events and coronary artery disease.