冠心病患者血浆同型半胱氨酸水平与冠状动脉病变SYNTAX积分的相关性研究

发布时间：2018-03-14 04:11

本文选题：冠心病　切入点：高半胱氨酸　出处：《中国全科医学》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨冠心病患者血浆同型半胱氨酸(Hcy)水平与冠状动脉病变SYNTAX积分的相关性。方法选取2014年7—12月在宁夏医科大学总医院心内科就诊并经冠状动脉造影术(CAG)明确诊断为冠心病的患者225例为冠心病组,同时选取CAG阴性的患者51例为对照组。根据SYNTAX积分将冠心病组患者进一步分为低危组(n=74)、中危组(n=72)和高危组(n=79)。收集患者的一般资料[包括性别、年龄、BMI、收缩压(SBP)、舒张压(DBP)、吸烟史、饮酒史、既往史、既往用药情况等]、实验室检查结果 [包括空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(SUA)、血肌酐(SCr)、超敏C反应蛋白(hs-CRP)、Hcy等]及心脏彩超检查结果 [包括左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)]。结果 4组年龄、SBP、DBP间差异无统计学意义(P0.05),而BMI间差异有统计学意义(P0.05)。4组男性比例、饮酒率及降糖药物、他汀类药物、抗血小板药物使用率间差异无统计学意义(P0.05),而吸烟率和高血压、糖尿病、高脂血症发生率及降压药物使用率间差异有统计学意义(P0.05)。4组FPG、TC、SUA、hs-CRP水平间差异无统计学意义(P0.05),而Hb A1c、TG、LDL-C、HDL-C、SCr、Hcy水平及LVEDD、LVEF间差异有统计学意义(P0.05)。Hcy水平与BMI、吸烟、高血压和Hb A1c、TC、LDL-C、SUA、SCr、hs-CRP水平及LVEDD呈正相关(P0.05),与HDL-C水平及LVEF呈负相关(P0.05);而与其他指标无明显相关(P0.05)。SYNTAX积分与高血压和SCr、Hcy水平及LVEDD呈正相关(P0.05),与TG、HDL-C水平及LVEF呈负相关(P0.05);而与其他指标无明显相关(P0.05)。多因素Logistic回归分析结果显示,吸烟、高血压和LDL-C、HDL-C、Hcy水平及LVEF是SYNTAX积分的独立影响因素(P0.05)。结论冠心病患者血浆Hcy水平与SYNTAX积分呈正相关,测定血浆Hcy水平有利于预测冠心病患者的冠状动脉病变复杂程度。
[Abstract]:Objective to investigate the correlation between plasma homocysteine cysteine (Hcy) level and coronary artery disease (SYNTAX) score in patients with coronary heart disease. 225 patients with coronary heart disease were diagnosed as coronary heart disease group. At the same time, 51 patients with negative CAG were selected as the control group. According to the SYNTAX score, the patients in the coronary heart disease group were further divided into two groups: low risk group (n = 74), middle risk group (n = 722) and high risk group (n = 79). General data of patients [including sex, age, SBP, DBP, DBP, DBP, smoking history were collected. History of drinking, past history, Results of laboratory tests [including fasting blood glucose FPGN, glycosylated hemoglobin HbA1cU, total cholesterol TCU, triacylglycerol TGN, low density lipoprotein cholesterol (LDL-CU), high density lipoprotein cholesterol (HDL-CU), serum uric acid (UAA), serum creatinine (SCR), The results of hypersensitive C-reactive protein (Hs-CRP) and color Doppler echocardiography [including left ventricular end-diastolic diameter (LVEDDN), left ventricular ejection fraction (LVEF)]. Results there was no significant difference in age group (P 0.05), but there was a significant difference in BMI among male patients (P 0.05.4). There was no significant difference in the use rate of alcohol and hypoglycemic drugs, statins and antiplatelet drugs, but there was no significant difference in smoking rate, hypertension, diabetes mellitus, There were significant differences in the incidence of hyperlipidemia and the utilization rate of antihypertensive drugs. There was no significant difference in the level of hs-CRP between FPGG and TCCS, but Hcy level in HDL-CU HDL-Cn and LVEDDLVEF in HBA1cTGN LDL-CU were significantly different from those of BMI.Hcy, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking, smoking. There was a positive correlation between the levels of hs-CRP and LVEDD and a negative correlation with HDL-C and LVEF between hypertension and HbA1cU TCU, but there was no significant correlation with other indexes (P0.05. SYNTAX score was positively correlated with the levels of Hcy and LVEDD in hypertension, SCrHcy and LVEDD), but negatively correlated with the levels of HDL-C and LVEF, but negatively correlated with other indexes. There was no significant correlation between the indexes (P 0.05). The results of multivariate Logistic regression analysis showed that, Smoking, high blood pressure and LDL-Con Hcy levels and LVEF were independent influencing factors of SYNTAX score (P 0.05). Conclusion the plasma Hcy level is positively correlated with SYNTAX score in patients with coronary heart disease. The determination of plasma Hcy level is helpful to predict the complexity of coronary artery disease in patients with coronary heart disease.
【作者单位】：宁夏医科大学总医院心脏中心;宁夏医科大学研究生院;
【基金】：2012年宁夏回族自治区教育厅项目(NGY2012057)
【分类号】：R541.4

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