血清同型半胱氨酸及尿酸水平检测对冠心病的临床价值研究

目的:探讨血清同型半胱氨酸(Hcy)和尿酸(UA)水平检测对冠心病的临床价值。方法:选择经冠状动脉造影确诊为冠心病的182例患者,分为以下3组,稳定型心绞痛(SAP)组78例,不稳定型心绞痛(UAP)组56例,急性心肌梗死(AMI)组48例。另外,随机选择单纯性高血压患者60例作为对照组,比较各组血清Hcy和UA水平并分析二者与各临床类型冠心病之间的关系。结果:⑴冠心病组的血清Hcy和UA水平明显高于单纯性高血压组(P0.05);⑵AMI组的血清Hcy和UA水平均明显高于UAP组和SAP组(P0.05);⑶Spearman相关分析显示:在AMl组中血清Hcy和UA水平呈高度正相关(P0.01);⑷Logistic风险回归显示:血清Hcy和血清UA升高是冠心病的危险因素(P0.05),而血清Hcy升高是急性心肌梗死的独立危险因素(P0.05)。结论:高Hcy与高UA血症是冠心病发病的重要危险因素,联合监测二者对预防冠心病尤其是急性心肌梗死具有重要的临床意义。

Study on the Clinical Value of SerumHomocysteine and Uric Acid levels in the Coronary Heart Disease

Objective： To investigate the clinical value of serum homocysteine and uric acid levels in the coronary heart disease （CHD）. Methods.＂ 182 patients with CHD diagnosed by coronary angioplasty were enrolled, including 78 SAP patients,m56 UAP patients and 48 AMI patients, while 60 patients with simple essential hypertension （EH） were selected as controls. The levels of serum Hcy and UA in all patients were determined, then their correlation with different groups were analyzed. Results： （1）The serum Hcy and UA conce- ntrations in CHD group were both higher than those in EH group （P〈0.05）. （2）Serum Hey and UA concentration in AMI group were higher than those in SAP and UAP groups （P〈0.05）. （3）Spearman correlation analysis indicated serum Hey and UA werer highly positive correlated in AMI group（P〈0.01）. （4）Logistic regression analysis indicated the increase of serum Hcy and UA levels were the risk factors in CHD, while the increase of serum Hcy was single risk factor in AMI patients. Conclusion： Hyperhomocysteinemia and Hyperuricemia were important risk factors in CHD, the detection of both serum Hcy and UA were of great importance in the prevention of CHD.