同型半胱氨酸、骨质疏松与老年冠心病的相关性研究

发布时间：2018-03-15 01:00

本文选题：冠心病　切入点：心绞痛　出处：《新乡医学院》2017年硕士论文　论文类型：学位论文

【摘要】：背景冠心病作为发病率和致死率目前都高、病因复杂、病机至今尚未完全揭晓、对人类身心健康影响较大、防治较为困难一个心血管病,与血同型半胱氨酸、骨质疏松的关系虽有一些研究,但关于老年冠心病心绞痛与血同型半胱氨酸、骨质疏松关系的循证学依据至今仍十分匮乏。目的分析同型半胱氨酸、骨质疏松之间及二者与老年冠心病心绞痛发生、严重程度之间的关系,为老年冠心病心绞痛的防治提供循证学依据。方法选取2015年1月至2016年12月就诊于郑州人民医院经冠状动脉造影确诊的70例老年冠心病心绞痛患者和70例无冠心病老年患者分别设为病例组、对照组,用Excel表格收集入组受试者的性别、年龄、烟酒史、高血压史、糖尿病史、血同型半胱氨酸(S-腺苷水解酶法检测)、跟骨骨密度(韩国超声骨密度仪测定)、心绞痛严重程度[用加拿大心血管病学会(Canadian Cardiovascular Society,CCS)分级]和冠状动脉狭窄程度[Gensini积分法]等资料,经SPSS20.0统计软件包用X~2检验、多因素Logistic模型筛选影响老年冠心病心绞痛发生的因素,用Spearman等级法分析血同型半胱氨酸、跟骨骨密度之间及二者与老年冠心病心绞痛严重程度之间的关系,P0.05为差异存在统计学意义。结果(1)X~2检验显示:烟酒史、高血压史、高同型半胱氨酸血症、糖尿病史、骨质疏松症是老年冠心病心绞痛发生的可疑影响因素(P0.05);(2)多因素Logistic回归分析显示:高血压史(β=0.529,OR=1.269)、高同型半胱氨酸血症(β=2.426,OR=2.983)、骨质疏松症(β=1.433,OR=2.015)是老年冠心病心绞痛发生的独立影响因素(P0.05)。(3)Spearman等级法统计显示:病例组,血同型半胱氨酸与CCS分级、Gensini总积分呈正相关(rs=0.624、0.807,P0.05),跟骨骨密度与CCS分级、Gensini总积分呈负相关(rs=-0.583、-0.727,P0.05),血同型半胱氨酸与跟骨骨密度呈负相关(rs=-0.753,P0.05);对照组血同型半胱氨酸与跟骨骨密度无明显相关性(P0.05)。结论高同型半胱氨酸血症、骨质疏松是老年冠心病心绞痛发生的独立危险因素,血同型半胱氨酸、跟骨骨密度与老年冠心病心绞痛严重程度关系密切,且二者呈负相关,临床中需加以重视。
[Abstract]:Background Coronary heart disease, as a high morbidity and fatality rate, has complicated etiology, and the pathogenesis has not been fully revealed, which has a great impact on human physical and mental health. It is difficult to prevent and cure a cardiovascular disease with homocysteine. Although there have been some studies on the relationship between osteoporosis and angina pectoris and homocysteine in the elderly, the evidence-based basis for the relationship between osteoporosis and osteoporosis is still very scarce. The relationship between osteoporosis and the occurrence and severity of angina pectoris in elderly patients with coronary heart disease. Methods from January 2015 to December 2016, 70 elderly patients with angina pectoris diagnosed by coronary angiography and 70 patients without coronary heart disease were selected from Zhengzhou people's hospital to provide evidence-based evidence for the prevention and treatment of angina pectoris of coronary heart disease. The elderly patients were divided into two groups. In the control group, sex, age, history of alcohol and tobacco, history of hypertension, history of diabetes mellitus were collected by Excel table. Serum homocysteine S-adenosine hydrolase assay, calcaneal bone mineral density (KUSBMD), severity of angina pectoris [Canadian Cardiovascular Society CCSs] and coronary artery stenosis [Gensini integration method], and so on. The factors influencing angina pectoris in elderly patients were screened by SPSS20.0 statistical software package Xn2 test, multivariate Logistic model, and homocysteine were analyzed by Spearman grade method. The relationship between calcaneal bone mineral density and the severity of angina pectoris in elderly patients with coronary heart disease (P 0.05) was statistically significant. Results: the history of alcohol and tobacco, hypertension, hyperhomocysteinemia, diabetes mellitus, and so on. Multivariate Logistic regression analysis showed that the history of hypertension (尾 0. 529), hyperhomocysteinemia (尾 2. 426) and osteoporosis (尾 1. 433OR2.015) were independent of angina pectoris in elderly patients. The influencing factors were as follows: case group, P0.05, Spearman's grade method, P0. 05%, P 0. 05, P 0. 05, P 0. 05. There was a positive correlation between serum homocysteine and CCS grade Gensini total score, a negative correlation between calcaneal bone mineral density and CCS grade Gensini total score, a negative correlation between serum homocysteine and calcaneal bone density, a negative correlation between serum homocysteine and calcaneal bone density, and a negative correlation between serum homocysteine and calcaneal bone mineral density, and a negative correlation between serum homocysteine and calcaneal bone mineral density, and a negative correlation between serum homocysteine and calcaneal bone density, and a negative correlation between serum homocysteine and calcaneal bone density. There was no significant correlation between density and P0.05.Conclusion hyperhomocysteinemia is associated with hyperhomocysteinemia. Osteoporosis is an independent risk factor of angina pectoris in elderly patients. Homocysteine and calcaneal bone mineral density are closely related to the severity of angina pectoris in elderly patients.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4;R580

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