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目的探讨同型半胱氨酸(HCY)与冠状动脉支架内再狭窄的相关性研究。方法选取2013年1-12月该院收治的行冠脉造影检查并置入雷帕霉素洗脱支架(DES)的患者100例。术后6个月后随访,24例发生狭窄,再狭窄率24%。对比无狭窄组及狭窄组患者的HCY水平。将HCY进行Logistic回归分析。根据HCY的检测水平,高HCY组60例患者,其中30例患者出院后长期服用叶酸,30例未服用。对比服用叶酸与未服用叶酸患者的HCY测定值及冠状动脉支架内再狭窄发生率。结果 HCY与冠状动脉支架术后再狭窄呈正相关(OR=0.971,95%CI=0.946-0.997,P=0.029),30例口服叶酸患者在服药6个月时同型半胱氨酸的测定值及冠状动脉支架内再狭窄发生率无明显变化,随访12个月同型半胱氨酸的测定值及冠状动脉支架内再狭窄发生率明显降低(P<0.05)。结论血浆HCY水平是造成冠状动脉支架内再狭窄的独立危险因素。长期口服叶酸能够降低血浆HCY的水平,降低冠状动脉支架内再狭窄发生率。
Objective To investigate the relationship between homocysteine (HCY) and coronary stent restenosis. Methods One hundred patients undergoing coronary angiography and rapamycin eluting stent (DES) were enrolled in this hospital from January to December in 2013. Six months after the operation, 24 cases had stenosis and restenosis rate was 24%. HCY levels in patients without stenosis and stenosis were compared. Logistic regression analysis of HCY. According to the level of HCY testing, 60 patients in the high-HCY group, 30 of whom had long-term folic acid supplements after discharge, were not taken in 30 patients. HCY levels in patients taking folic acid versus non-taking folic acid and incidence of coronary stent restenosis were compared. Results There was a positive correlation between HCY and restenosis after coronary stenting (OR = 0.971, 95% CI = 0.946-0.997, P = 0.029). The measured value of homocysteine in 30 patients with oral folic acid at 6 months and Coronary artery stent restenosis rate did not change significantly at 12 months follow-up homocysteine and coronary stent restenosis was significantly lower (P <0.05). Conclusions Plasma HCY level is an independent risk factor for coronary stent restenosis. Long-term oral folic acid can reduce the level of plasma HCY and reduce the incidence of coronary stent restenosis.