| 史 菲,张 娜,孙王乐贤,龙 森,韩 超,丁振江.血清同型半胱氨酸、叶酸、维生素B12水平与冠状动脉病变严重程度的相关性分析[J].,2020,(23):4478-4482 |
| 血清同型半胱氨酸、叶酸、维生素B12水平与冠状动脉病变严重程度的相关性分析 |
| Analysis of the Correlation of Serum Homocysteine, Folic Acid and Vitamin B12 Levels with the Severity of Coronary Artery Disease |
| 投稿时间：2020-07-30 修订日期：2020-08-28 |
| DOI：10.13241/j.cnki.pmb.2020.23.017 |
| 中文关键词: 冠状动脉病变 同型半胱氨酸 叶酸 维生素B12 相关性 |
| 英文关键词: Coronary artery disease Homocysteine Folic acid Vitamin B12 Correlation |
| 基金项目:河北省科技计划项目（17277769D）；承德市科技支撑计划项目（201701A072） |
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| 中文摘要: |
| 摘要 目的：探讨血清同型半胱氨酸(homocysteine, Hcy)、叶酸、维生素B12水平与冠状动脉病变严重程度的相关性。方法：选取经冠脉造影检查确诊的稳定期冠心病患者220例为研究组，并以同期健康查体志愿者100例为对照组。检测和比较两组血清Hcy、叶酸、维生素B12和N -末端脑钠肽前体(N-terminal brain natriuretic peptide precursor，NT-proBNP)水平。研究组根据冠脉造影情况进行SYNTAX评分评价，通过心脏超声检查检测左室射血分数(left ventricular ejection fraction，LVEF)，确定冠脉病变严重程度。比较研究组SYNTAX低分组(1～22分)、中分组(23～32分)和高分组(≥33分)患者上述各指标水平，并分析研究组血清Hcy、叶酸、维生素B12水平与其血清NT-proBNP 水平、SYNTAX评分和LVEF的关系。结果：与对照组比较，研究组血清Hcy和NT-proBNP水平升高而血清叶酸、维生素B12水平降低(P＜0.05)。研究组SYNTAX评分和LVEF分别为(28.76±6.58)分和(47.33±8.66)%，SYNTAX中分和高分患者血清Hcy和NT-proBNP水平高于SYNTAX低分患者而血清叶酸、维生素B12水平和LVEF则低于SYNTAX低分患者，SYNTAX高分患者血清Hcy和NT-proBNP水平高于SYNTAX中分患者而血清叶酸、维生素B12水平和LVEF则低于SYNTAX中分患者(P＜0.05)。Pearson线性相关分析结果显示研究组血清Hcy水平与其血清NT-proBNP 水平、SYNTAX评分均呈正相关(r=0.881，0.793，P＜0.05)，与其LVEF则呈负相关(r=-0.876，P＜0.05)；而其血清叶酸、维生素B12水平与其血清NT-proBNP 水平、SYNTAX评分均呈负相关(叶酸：r=-0.786，-0.825；维生素B12：r=-0.884，-0.818，P＜0.05)，与其LVEF则呈正相关(r=0.893，0.859，P＜0.05)。结论：血清Hcy是冠心病的重要危险因素，其水平随着冠状动脉病变程度加重而升高；血清叶酸、维生素B12是冠心病的保护因素，其水平随着冠状动脉病变程度加重而降低。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation of serum homocysteine (Hcy), folic acid and vitamin B12 levels with the severity of coronary artery disease. Methods: 220 patients with stable coronary heart disease diagnosed by coronary angiography were selected as the study group, and 100 healthy volunteers were selected as the control group. Serum levels of Hcy, folic acid, vitamin B12 and N-terminal brain natriuretic peptide precursor (NT-proBNP) were measured and compared between the two groups. The study group was evaluated by SYNTAX score based on coronary angiography, and left ventricular ejection fraction (LVEF) was detected by echocardiography to determine the severity of coronary artery disease. The above indexes of SYNTAX patients with low score (1~22 points), middle score (23~32 points) and high score (≥ 33 points) in the study group were compared. The relationship between serum Hcy, folic acid, vitamin B12 levels with serum NT-proBNP level, SYNTAX score and LVEF in the study group was analyzed. Results: Compared with those of the control group, the serum levels of Hcy and NT-proBNP level of the study group increased while the serum levels of folic acid and vitamin B12 level in the study group decreased (P<0.05). The average SYNTAX score and LVEF in the study group were (28.76±6.58) and (47.33±8.66) % respectively. The serum levels of Hcy and NT-proBNP in patients with middle and high SYNTAX score were higher than those in patients with low SYNTAX score, while serum levels of folic acid, vitamin B12 and LVEF in patients with middle and high SYNTAX score were lower than those in patients with low SYNTAX score; The serum levels of Hcy and NT-proBNP in patients with high SYNTAX score were higher than those in patients with middle SYNTAX score, while serum levels of folic acid, vitamin B12 and LVEF in patients with high SYNTAX score were lower than those in patients with middle SYNTAX score(P<0.05). Pearson linear correlation analysis showed that serum Hcy level was positively correlated with serum NT-proBNP level and SYNTAX score (r=0.881, 0.793, P<0.05), negatively correlated with LVEF (r=-0.876, P<0.05), while serum folic acid and vitamin B12 levels were negatively correlated with serum NT-proBNP level and SYNTAX score (folic acid: r=-0.786, -0.825; 12: r=-0.884, -0.818, P<0.05), which was positively correlated with the LVEF (r = 0.893, 0.859, P<0.05). Conclusion: Serum Hcy is an important risk factor for coronary heart disease and its level increases with the aggravation of coronary artery lesions. In contrast, serum folic acid and vitamin B12 are protective factors and their levels decrease with the aggravation of coronary artery lesions. |
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