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目的:探讨血清同型半胱氨酸( HCY)水平与冠心病( CHD)的关系。方法:采用荧光偏振免疫分析法( FPIA)对1 5 3例行冠状动脉造影患者测定HCY水平。冠脉造影显示3支冠脉中至少1支血管病变狭窄≥5 0 %者为CHD组( 1 0 5例) ,3支血管中任一血管狭窄程度均<5 0 %者为对照组( 4 8例)。CHD患者进一步分为1支病变组( 2 5例) ,2支病变组( 31例)及3支病变组( 4 9例)。结果:1 CHD组血清HCY水平明显高于对照组( P<0 .0 0 1 ) ,且CHD组中高HCY血症发生率明显高于对照组( P<0 .0 0 1 ) ;2 0、1、2、3支血管病变者血清HCY浓度呈逐级增高趋势,0支病变组与其它各病变组间比较均相差非常显著( P<0 .0 0 1 ) ,1支、2支、3支病变组间差异无统计学意义;3不同临床类型患者,HCY水平急性心肌梗死( AMI) >陈旧性心肌梗死( OMI) >不稳定型心绞痛( UAP) >稳定型心绞痛( SAP)>其它( Other) ,其中AMI组与UAP组相比较差异显著( P<0 .0 1 )、AMI与SAP组、AMI与Other组间比较均有显著性显著( P<0 .0 0 1 )。结论:CHD患者血清HCY水平明显增高,高HCY血症所占比例较大,且血清HCY浓度随冠脉病变程度加重呈上升趋势,CHD活动性病变较稳定性病变HCY浓度增高,提示HCY与冠状动脉病变的发生发展可能有直接关系,是CHD可能的危险因素
Objective: To investigate the relationship between serum homocysteine (HCY) and coronary heart disease (CHD). Methods: Fluorescence polarization immunoassay (FPIA) was used to measure HCY levels in 153 patients undergoing coronary angiography. Coronary angiography showed that at least one of the three coronary arteries had a stenosis of ≥50% in the CHD group (105 cases), and the degree of stenosis in any of the three vessels was <50% in the control group (4 8 cases). CHD patients were further divided into one lesion group (25 cases), 2 lesions group (31 cases) and 3 lesions group (49 cases). Results: The serum HCY level in CHD group was significantly higher than that in control group (P <0.01), and the incidence of hypervolemic hypervolemia in CHD group was significantly higher than that in control group (P <0.01) The serum HCY concentrations in 1, 2 and 3 vessel lesions showed a trend of increasing step by step. The difference between the 0 and 2 groups was significant (P <0.01), 1, 2 and 3 There was no significant difference between the two groups. (3) In patients with different clinical types, patients with acute myocardial infarction (AMI)> old myocardial infarction (OMI)> unstable angina (UAP)> stable angina pectoris (SAP) There was significant difference between AMI group and UAP group (P <0.01). There was significant difference between AMI and SAP group, AMI and Other groups (P <0.01). Conclusions: Serum HCY levels in patients with CHD were significantly higher than those in patients with hypercholesterolemia, and serum HCY concentrations increased with the severity of coronary lesions. HCY concentrations in CHD patients with active disease were higher than those with stable disease, suggesting that HCY and coronary The development of arterial disease may have a direct relationship, is a possible risk factor for CHD