摘要
目的观察和分析超敏C反应蛋白(high sensitive C-reactive protein,hsCRP)水平正常者血清Hcy浓度与冠状动脉病变(coronary artery disease,CAD)的关系。方法纳入2017年4月至2019年4月期间在西安交通大学第一附属医院心内科接受冠状动脉造影且hsCRP≤2.0 mg/L的患者共4 097例,其中男性2 787例,女性1 310例。按照血清Hcy三分位数水平将所有入选者分为高(>19.40μmol/L)、中(>13.90~19.40μmol/L)、低(≤13.90μmol/L)3组,比较各组入选病例基线和临床生化指标的差异,Logistic回归分析评估Hcy浓度与CAD患病率及严重程度的关系。结果高Hcy组的CAD严重程度较低Hcy组更重(Gensini评分35.39±33.95 vs 26.25±27.04,P<0.001),且血清Hcy浓度与Gensini评分显著正相关(r=0.122,P<0.001);高Hcy组的急性心肌梗死(15.2%vs 9.2%,P<0.001)和三支病变比例(34.8%vs 29.0%,P=0.004)显著高于低Hcy组;Logistic回归分析显示在校正所有基线差异后,血清Hcy浓度仍然与CAD的患病率(P=0.006)、急性心肌梗死(P=0.001)和更严重的CAD(P=0.002)显著正相关。结论在hsCRP水平正常者中,血清Hcy浓度是CAD患病率和严重程度的独立预测因子。
Objective To observe and analyze the relationship between serum Hcy concentration and coronary artery disease(CAD) in patients with normal high-sensitivity C-reactive protein(hsCRP) level. Methods A total of 4 097 patients(2 787 males and 1 310 females) who underwent coronary angiography and had hsCRP ≤2.0 mg/L in the Department of Cardiology, First Affiliated Hospital of Xi’an Jiaotong University from April 2017 to April 2019 were enrolled in this study. According to serum Hcy level in the tertile, they were divided into high, middle and low level groups(>19.40, >13.90~19.40, ≤13.90 μmol/L). The differences in baseline data and clinical biochemical parameters were compared among the groups. Logistic regression analysis was used to evaluate the relationship between Hcy concentration with CAD prevalence and severity. Results The severity of CAD was more serious in the high Hcy group than the low Hcy group(Gensini score: 35.39±33.95 vs 26.25±27.04, P<0.001), and the serum Hcy level was significantly positively correlated with the Gensini score(r=0.122, P<0.001). The incidence rates of acute myocardial infarction(15.2% vs 9.2%, P<0.001) and three-vessel disease(34.8% vs 29.0%, P=0.004) were significantly higher in the high Hcy group than low Hcy group. Logistic regression analysis showed that after adjustment for all baseline differences, serum Hcy level was still positively correlated with the prevalence(P=0.006) and severity(P=0.002) of CAD and the incidence of acute myocardial infarction(P=0.001). Conclusion Serum Hcy may be an independent predictor of CAD prevalence and severity in patients with normal hsCRP level.
作者
伍俊
周娟
袁祖贻
郜珊珊
王丽君
WU Jun;ZHOU Juan;YUAN Zuyi;GAO Shanshan;WANG Lijun(Department of Cardiology,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi Province,710061;Department of Neurology,Xi’an Gaoxin Hospital,Xi’an,Shaanxi Province,710075;Key Laboratory of Molecular Cardiology,Xi’an,Shaanxi Province,710061;Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education,Xi’an Jiaotong University,Xi’an,Shaanxi Province,710061,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2019年第21期2132-2136,共5页
Journal of Third Military Medical University
基金
陕西省自然科学基础研究计划(2018JM7106)
西安交通大学第一附属医院临床研究基金(XJTU1AF-CRF-2018-010)~~
