中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
5期
580-582
,共3页
宋艳东%张京梅%王苏%陶英%李志忠
宋豔東%張京梅%王囌%陶英%李誌忠
송염동%장경매%왕소%도영%리지충
半胱氨酸%冠心病%血管成形术,气囊,冠状动脉%SYNTAX评分
半胱氨痠%冠心病%血管成形術,氣囊,冠狀動脈%SYNTAX評分
반광안산%관심병%혈관성형술,기낭,관상동맥%SYNTAX평분
Cysteine%Coronary artery disease%Angioplasty,balloon,coronary%SYNTAX score
目的 探讨血清同型半胱氨酸(Hcy)水平与冠状动脉病变严重程度的关系.方法 回顾性分析2012年1-12月在首都医科大学附属北京安贞医院心内科15病房住院行冠状动脉造影检查的512例冠心病患者的病历资料.根据SYNTAX评分结果分为低危、中危和高危组,分别为172、195和145例.选同期行冠状动脉造影检查结果正常者为正常组(180例).测定4组患者血清Hcy、TC、TG、HDL-C和LDL-C水平；比较各组患者血脂、血清Hcy水平的差异,评价血清Hcy与血脂和SYNTAX评分的关系；根据血脂和血清Hcy结果进行冠心病危险因素分析.结果 ①中危组及高危组患者TC、LDL-C和血清Hcy水平与正常组的差异有统计学意义[中危组TC、LDL-C和血清Hcy水平分别为(6.1±0.7) mmol/L、(3.7±1.0)mmol/L和(16.4±2.0)μmol/L,高危组分别为(7.2 ±0.9)mmol/L、(4.2±1.1) mmol/L和(19.5±1.8) μmol/L,正常组分别为(4.5 ±0.5)mmol/L、(2.9 ±0.7) mmol/L和(10.8±0.4) μmol/L,P＜0.05],余观察指标的组间差异均无统计学意义(P＞0.05).②512例患者中血清Hcy水平正常者272例,其TC、TG、HDL-C、LDL-C和SYN-TAX评分分别为(5.1±1.1) mmol/L、(1.4 ±1.1) mmol/L、(1.2±0.3)mmol/L、(3.5±0.9) mmol/L和(19±10)分；血清Hcy高水平者240例,其TC、TG、HDL-C、LDL-C和SYNTAX评分分别为(5.1±1.2) mmol/L、(1.4±1.6) mmol/L、(1.2±0.3)mmol/L、(3.5±1.0) mmol/L和(26±11)分.高Hcy水平患者SYNTAX评分与Hcy水平正常者的差异有统计学意义(P＜0.05),而正常和高Hcy水平患者的TC、TG、HDL-C和LDL-C的差异无统计学意义(P＞0.05).③Logistic多元回归分析结果显示Hcy、TC、LDL-C与冠心病相关(Hcy:r=0.24、TC:r =0.32、LDL-C:r =0.26,均P＜0.05).结论 血清Hcy水平是冠状动脉病变严重程度的危险因素,随着血清Hcy水平的增高,冠状动脉病变程度增加.
目的 探討血清同型半胱氨痠(Hcy)水平與冠狀動脈病變嚴重程度的關繫.方法 迴顧性分析2012年1-12月在首都醫科大學附屬北京安貞醫院心內科15病房住院行冠狀動脈造影檢查的512例冠心病患者的病歷資料.根據SYNTAX評分結果分為低危、中危和高危組,分彆為172、195和145例.選同期行冠狀動脈造影檢查結果正常者為正常組(180例).測定4組患者血清Hcy、TC、TG、HDL-C和LDL-C水平；比較各組患者血脂、血清Hcy水平的差異,評價血清Hcy與血脂和SYNTAX評分的關繫；根據血脂和血清Hcy結果進行冠心病危險因素分析.結果 ①中危組及高危組患者TC、LDL-C和血清Hcy水平與正常組的差異有統計學意義[中危組TC、LDL-C和血清Hcy水平分彆為(6.1±0.7) mmol/L、(3.7±1.0)mmol/L和(16.4±2.0)μmol/L,高危組分彆為(7.2 ±0.9)mmol/L、(4.2±1.1) mmol/L和(19.5±1.8) μmol/L,正常組分彆為(4.5 ±0.5)mmol/L、(2.9 ±0.7) mmol/L和(10.8±0.4) μmol/L,P＜0.05],餘觀察指標的組間差異均無統計學意義(P＞0.05).②512例患者中血清Hcy水平正常者272例,其TC、TG、HDL-C、LDL-C和SYN-TAX評分分彆為(5.1±1.1) mmol/L、(1.4 ±1.1) mmol/L、(1.2±0.3)mmol/L、(3.5±0.9) mmol/L和(19±10)分；血清Hcy高水平者240例,其TC、TG、HDL-C、LDL-C和SYNTAX評分分彆為(5.1±1.2) mmol/L、(1.4±1.6) mmol/L、(1.2±0.3)mmol/L、(3.5±1.0) mmol/L和(26±11)分.高Hcy水平患者SYNTAX評分與Hcy水平正常者的差異有統計學意義(P＜0.05),而正常和高Hcy水平患者的TC、TG、HDL-C和LDL-C的差異無統計學意義(P＞0.05).③Logistic多元迴歸分析結果顯示Hcy、TC、LDL-C與冠心病相關(Hcy:r=0.24、TC:r =0.32、LDL-C:r =0.26,均P＜0.05).結論 血清Hcy水平是冠狀動脈病變嚴重程度的危險因素,隨著血清Hcy水平的增高,冠狀動脈病變程度增加.
목적 탐토혈청동형반광안산(Hcy)수평여관상동맥병변엄중정도적관계.방법 회고성분석2012년1-12월재수도의과대학부속북경안정의원심내과15병방주원행관상동맥조영검사적512례관심병환자적병력자료.근거SYNTAX평분결과분위저위、중위화고위조,분별위172、195화145례.선동기행관상동맥조영검사결과정상자위정상조(180례).측정4조환자혈청Hcy、TC、TG、HDL-C화LDL-C수평；비교각조환자혈지、혈청Hcy수평적차이,평개혈청Hcy여혈지화SYNTAX평분적관계；근거혈지화혈청Hcy결과진행관심병위험인소분석.결과 ①중위조급고위조환자TC、LDL-C화혈청Hcy수평여정상조적차이유통계학의의[중위조TC、LDL-C화혈청Hcy수평분별위(6.1±0.7) mmol/L、(3.7±1.0)mmol/L화(16.4±2.0)μmol/L,고위조분별위(7.2 ±0.9)mmol/L、(4.2±1.1) mmol/L화(19.5±1.8) μmol/L,정상조분별위(4.5 ±0.5)mmol/L、(2.9 ±0.7) mmol/L화(10.8±0.4) μmol/L,P＜0.05],여관찰지표적조간차이균무통계학의의(P＞0.05).②512례환자중혈청Hcy수평정상자272례,기TC、TG、HDL-C、LDL-C화SYN-TAX평분분별위(5.1±1.1) mmol/L、(1.4 ±1.1) mmol/L、(1.2±0.3)mmol/L、(3.5±0.9) mmol/L화(19±10)분；혈청Hcy고수평자240례,기TC、TG、HDL-C、LDL-C화SYNTAX평분분별위(5.1±1.2) mmol/L、(1.4±1.6) mmol/L、(1.2±0.3)mmol/L、(3.5±1.0) mmol/L화(26±11)분.고Hcy수평환자SYNTAX평분여Hcy수평정상자적차이유통계학의의(P＜0.05),이정상화고Hcy수평환자적TC、TG、HDL-C화LDL-C적차이무통계학의의(P＞0.05).③Logistic다원회귀분석결과현시Hcy、TC、LDL-C여관심병상관(Hcy:r=0.24、TC:r =0.32、LDL-C:r =0.26,균P＜0.05).결론 혈청Hcy수평시관상동맥병변엄중정도적위험인소,수착혈청Hcy수평적증고,관상동맥병변정도증가.
Objective To evaluate the correlation between serum homocysteine (Hcy) level and coronary lesion severity in coronary artery disease(CAD) patients.Methods A total of 512 patients receiving coronary angiography from January 2012 to December 2012 were retrospectively analyzed.According to SYNTAX score,CAD patients were divided into three groups:low-risk group (172 cases),middle-risk group (195 cases) and high risk group(145 cases).One hundred and eighty cases of normal coronary angiography over the same period were seemed as normal group.Fasting serum Hcy levels,fasting blood lipids including total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were determined.Results ①TC,LDL-C and Hcy were significantly higher in SYNTAX score high-risk group and middle-risk group compared with normal group.There was no statistically significant difference between the normal group and the low-risk group [TC,LDL-C and Hcy in middle-risk group were:(6.1 ± 0.7) mmol/L,(3.7 ± 1.0) mmol/L and (16.4 ± 2.0) μmol/L; In high-risk group were (7.2 ± 0.9) mmol/L,(4.2 ± 1.1) mmol/L and (19.5 ±1.8) μmol/L; In normal group were (4.5 ± 0.5) mmol/L,(2.9 ± 0.7) mmol/L and (10.8 ± 0.4) μmol/L,P ＜0.05].②272 cases had normal Hcy in 512 CAD patients.TC,TG,HDL-C,LDL-C and SYNTAX of them were (5.1 ±1.1)mmol/L,(1.4 ± 1.1)mmol/L,(1.2 ±0.3)mmoL/L,(3.5 ±0.9) mmol/L and (19 ± 10)scores; in high Hcy group,TC,TG,HDL-C,LDL-C and SYNTAX were (5.1 ± 1.2) mmol/L,(1.4 ± 1.6) mmol/L,(1.2 ± 0.3) mmol/L,(3.5 ± 1.0) mmol/L and (26 ± 11) scores.The SYNTAX score was significantly higher in high Hcy group than in normal group (P ＜ 0.05).③Multivariate Logistic regression analysis indicated that serum Hcy,TC,LDL-C were associated with coronary lesion severity(Hcy:r =0.24,TC:r =0.32,LDL-C:r =0.26,all P ＜ 0.05).Conclusions Serum Hcy is the risk factor of coronary lesion severity.With the increased Hcy level,the increase in the degree of coronary artery lesions,represent a greater cardiovascular risk.
