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目的探讨冠心病老年病人冠状动脉造影Gensini评分、收缩压(SBP)和舒张压(DBP)与其体内血清同型半胱氨酸(Hcy)水平和三酰甘油(TG)水平相关性。方法选择150例冠心病老年病人作为研究对象,所有病人都经过冠状动脉造影确诊,计算Gensini评分、记录SBP值、DBP值,采用酶联免疫法(ELISA)检测血清中Hcy水平,与此同时检测TG水平,并就血清Hcy、TG水平和Gensini评分、血压之间的关系做分析,随访时做好血管狭窄和病情进展情况的记录,以此分析病情进一步发展及与入院时Hcy水平的相关性。结果 Logistics回归分析数据显示,血清Hcy水平可能是Gensini评分的独立影响因素(Hcy的β值=3.118,S.E=0.561,Waldχ2值=30.925,P=0.001,95%CI=7.532~67.838,P<0.05),Gensini评分与性别、体质量指数(BMI)、SBP、DBP、TG水平没有明显的相关性(P>0.05),对病情发展做进一步分层分析显示,Gensini评分进展病人与未明显进展病人相比有明显的入院时高Hcy水平,这种类似的结局同样出现在病情进展(心绞痛发作次数≥3次/天)病人中(P<0.05)。结论老年冠心病病人的早期预测冠心病进展和预后的重要物理学指标可能是血清Hcy水平,但是量化标准有待进一步证实。
Objective To investigate the relationship between Gensini coronary artery angiography (Gensini score), systolic blood pressure (SBP) and diastolic blood pressure (DBP) and serum homocysteine (Hcy) and triglyceride (TG) levels in elderly patients with coronary heart disease. Methods A total of 150 elderly patients with coronary heart disease were selected as study subjects. All patients were diagnosed by coronary angiography, Gensini score was calculated, SBP value and DBP value were recorded. Serum Hcy level was detected by enzyme-linked immunosorbent assay (ELISA) TG levels, and serum Hcy, TG levels and Gensini score, the relationship between blood pressure analysis, follow-up of vascular stenosis and progression of the disease record, in order to analyze the further development of the disease and admission Hcy level correlation . Results The logistic regression analysis showed that serum Hcy level was an independent predictor of Gensini score (β = 3.118, SE = 0.561, Waldχ2 = 30.925, P = 0.001, 95% CI = 7.532-67.838, P <0.05 ), There was no significant correlation between Gensini score and gender, body mass index (BMI), SBP, DBP, TG levels (P> 0.05) .A further stratified analysis of the disease progression showed that the Gensini score progressing patients and the patients with no obvious progress This similar outcome was also seen in patients with progression of disease (≥3 beats / day of angina pectoris) (p <0.05) as compared with a clear high Hcy level at admission. Conclusion It is possible that serum Hcy level is an important physical indicator for the early prediction of coronary heart disease progression and prognosis in elderly patients with coronary heart disease. However, the quantitative criteria need to be further confirmed.