冠状动脉粥样硬化性心脏病患者同型半胱氨酸与血脂指标的相关性分析*

Correlation analysis of homocysteine level and blood lipid profile in patients with coronary heart disease*

摘要:

目的?探讨冠状动脉粥样硬化性心脏病（以下简称冠心病）患者同型半胱氨酸水平（Hcy）与甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）、脂蛋白a水平的相关性，进一步阐明Hcy与冠心病病理生理过程中的重要作用。方法?选取2016年1月1日—2018年12月31日于新疆医科大学第一附属医院住院确诊为冠心病的患者400例作为研究组。另取同期该院健康体检者390例作为对照组。分别对两组Hcy与各项血脂指标间进行Kendall'stau-b相关性检验；比较Hcy<15μmmol/L及≥15μmmol/L时的血脂水平，并对结果进行分析。结果?研究组Hcy水平较对照组高（P?<0.05），TG、TC、LDL-C、ApoA1、ApoB较对照组低（P?<0.05）。研究组Hcy与TG、TC、LDL-C、ApoA1及ApoB呈正相关（r?=0.231、0.184、0.137、0.117和0.162，P?<0.05）。Hcy≥15μmmol/L组TG、TC、LDL-C、脂蛋白a、ApoA1及ApoB较Hcy<15μmmol/L组高。结论?Hcy为冠心病的独立危险因素。Hcy与血脂水平有相关性。建议降脂治疗的同时降低血浆Hcy水平可能有助于预防冠心病的发生和发展。

Abstract:

Objective To investigate the correlation between homocysteine level and triglyceride, low density lipoprotein, total cholesterol, high density lipoprotein, apolipoprotein A1, apolipoprotein B and lipoprotein(a) levels in patients with coronary heart disease. Methods A total of 400 patients with coronary heart disease and 390 healthy controls in our hospital from January 1st 2016 to December 31st 2018 were selected for the study. Kendall’s tau-b correlation test was used to observe the correlation between homocysteine level and blood lipid profile in these two groups. Blood lipid levels when homocysteine levels < 15 μmol/L and ≥ 15 μmol/L were compared and the results were analyzed. Results Homocysteine level in coronary heart disease group was significantly higher than that in normal control group, while triglyceride, total cholesterol, low density lipoprotein, apolipoprotein A1 and apolipoprotein B levels were lower than those in the control group (P??0.05). The levels of triglyceride, total cholesterol, apolipoprotein A1, apolipoprotein B, lipoprotein(a) and low density lipoprotein in homocysteine levels ≥ 15 μmol/L group were significantly higher than those in homocysteine levels < 15 μmol/L group (P?