血浆同型半胱氨酸与冠心病相关性的临床研究.doc

血浆同型半胱氨酸与冠心病相关性的临床研究 　　作者：蒋华， 周云， 王晓峰 作者单位：(新疆医科大学附属中医医院心血管科， 新疆乌鲁木齐830000) 　　【摘要】目的：研究同型半胱氨酸(HCY)与冠心病(CHD)不同临床类型之间的关系。方法：选择2007年1～12月在我院住院的110例CHD患者及同期住院经冠状动脉造影、超声心动图及其他检查证实无器质性心脏病的患者30例作为对照，CHD患者按WHO诊断标准，分为急性心肌梗死组(28例)、不稳定型心绞痛组(34例)、稳定型心绞痛组(48例)。采用循环酶法检测各组患者血浆HCY水平。结果：CHD患者血浆HCY水平较对照组明显增高，差异具有统计学意义(P0.01)，急性心肌梗死组和不稳定型心绞痛组血浆HCY水平较稳定型心绞痛组及对照组明显升高，差异具有统计学意义(P0.01)。结论：HCY作为独立的动脉粥样硬化危险因素，对冠心病的诊断有重要的临床意义，可作为判定冠心病患者冠状动脉病变稳定性和严重性的指标之一。 　　【关键词】 冠心病;　同型半胱氨酸; 动脉粥样梗化 　　The correlation between plasma homocysteine and coronary heart disease 　　JIANG Hua，ZHOU Yun, WANG Xiaofeng 　　(Department of Cardiology, Affiliated Traditional Chinese Medicine Hospital, Xingjiang Medical University， Urumqi 830000, China) 　　Abstract: Objective： To investigate the correlation between plasma homocysteine (HCY) and type of coronary heart disease (CHD).Methods： One hundred and ten patients with CHD and 30 patients without cardiopathy according to the results of coronary artery angiography, echocardiography and other examination were enrolled from January 2007 to December 2007. According to WHO diagnostic standard, the CHD group were divided into acute myocardial infarction (AMI), unstable angina (UA), stable angina(SA). HCY levels were measured by Enzymatic cycling assay. Results：HCY level was significantly higher in CHD group than that in control group (20.43±10.72) Μmol/l vs(9.89±2.51) Μmol/l(P0.01). There was a significantly higher incidence of hyperhomocysteinemia in CHD group than those in control group (69.1% vs 31.4%, P0.01). HCY was also associated with diagnostic classifications, which was higher in diseases with active lesions. Conclusion： As an independent risk factor of atherosclerosis, HCY may play important roles in diagnosis of CHD, it may be one of the predictors of stability and severity in coronary lesions. 　　Key words： coronary heart disease;homocysteine; atherosclerosis 　　同型半胱氨酸(homocysteine,HCY)又称高半胱氨酸，是蛋氨酸代谢过程中产生的一种含硫氨基酸。自McCul1969年提出同型半胱氨酸血症可能