Study On Relation Between The Level Of Homocysteine And The Severity Of Coronary Heart Disease

Objective: Through the comparison and observation of different plasmahomocysteine levels in the change of clinical value in patients with coronaryheart disease (CHD), To analyze plasma homocysteine levels and severity ofcoronary artery lesions (expressed as a SYNTAX score) relationship.Methods: In July2012to October2013in between heart one of hospitalof hebei medical university the second line of230patients of coronaryangiography as the research object143cases including men, average age was56.8±10.3years old.63women, average age was61.4±7.8years old.Amongthem except to severe anemia, heart failure, liver and kidney function is notcomplete, thyroid function is low, malignant tumor, organ transplantation,scleroderma, psoriasis, oral contraceptives, patients with oral folic acid,vitamin B12, etc.Both in patients with preoperative acquisition elbow venousblood homocysteine levels, and based on the SYNTAX score of patients aftercoronary angiography results into low-risk groups (SYNTAX score of0-22points), moderate group (SYNTAX score23-32points), high-risk groups(SYNTAX score higher than33points).After coronary angiography did notsee clear lesions is defined as a control.Application of single factor varianceanalysis and comparison between the four groups of blood homocysteinelevels， And apply the spearman correlation analysis, the research level ofhomocysteine (HCY) and coronary angiography SYNTAX score (i.e.,coronary artery lesion severity) correlationship，Finally using multiple linearregression analysis, analysis of coronary artery disease severity and therelationship between the various factors, to explore the risk factors forcoronary artery lesion severity.All data using SPSS13.0software package forstatistical processing and analysis are all with P <0.05for the difference wasstatistically significant. Results:1Coronary heart disease group levels of plasma homocysteine(Hcy) is significantly higher than the control group (with a mean of18.19±2.18), the difference between the two groups (P <0.05);Plasma homocysteinelevels between groups in terms of coronary heart disease (Hcy) found thathigh risk group (average26.50±2.56)> moderate group (average24.78±2.21)> low-risk group (average26.97±3.72), the difference between groups(P <0.05).The linear correlation analysis showed that plasma homocysteinelevels in patients with coronary heart disease (Hcy) and is closely relatedbetween the SYNTAX score, the correlation coefficient of0.575；Uric acidvalue of coronary heart disease group is significantly higher than the controlgroup, P value=0.00(P <0.05)，Coronary heart disease (CHD) in patientswith HSCRP level higher than the control group, P <0.05.2The adjusted forage, sex, homocysteine levels, hypertension, diabetes, hypersensitivec-reactive protein (HSCRP), creatine kinase (CK), creatinine (Scr), fastingplasma glucose, the influence of such factors as homocysteine andhypersensitive c-reactive protein is the severity of coronary artery associatedrisk factors (i.e., the SYNTAX score).Levels of homocysteine levels higherthan men with women, and there are statistically significant differences (P <0.05)， Levels of homocysteine levels in patients with smoking andnonsmoking patients with statistical difference (P <0.05).Conclusions:1Coronary heart disease (CHD) in patients with plasmahomocysteine levels are significantly higher and the non coronary heartdisease (CHD) patients with coronary heart disease (CHD) SYNTAX scorewere positively correlated.2The higher the level of homocysteine (Hcy), inpatients with coronary artery stenosis degree is heavier, can react in a certainextent, the severity of coronary heart disease (CHD).3Patients with coronaryheart disease (CHD) of Hcy, uric acid (UA), HSCRP level were significantlyhigher than that of control group, the three indicators can be regarded as is arisk factor for coronary heart disease patients with acute coronary events, butits clinical significance still needs further research and discussion.4Theadjusted for age, gender, history of hypertension, diabetes, smoking history, creatine kinase (CK), creatinine (Scr), fasting plasma glucose, the influence ofsuch factors as homocysteine and hypersensitive c-reactive protein is theseverity of coronary artery (namely SYNTAX score) independent risk factors.