The Associativity Between The Change Of Plasma Homocystein And Lipoptein In Patients With Coronary Heart Disease

Objective :The incidence of coronary heart disease (CHD)is increasing gradually. CHD has been a fatal disease thatinfluence the health of humanbeings. To study the pathology,pathogenesis and control the risk factors of CHD, it is animportant task for medical study. Plaque rapture plays aimportant role in the course of occurrence and development ofCHD at the basis of coronary artery atherosclerosis, leading tocoronary artery stenosis even total occlusion. The dysfunction ofendothelium, smooth muscle cell proliferation, activation ofblood platelet and thrombosis embolism are main mechanisms.The pathogeny of CHD is not clear yet, but here are manyrisk factors for it. Homocysteine is a new risk factor of CHD,which differ from other conventional risk factors such assmoking, sex, age, blood pressure, diabetes , lipid disorders.This study alter the level of plasma homocystein by folicacid and VitaminB12 and investigate the relationship betweenHCY and lipid, especially TC, TG, LDL-C, HDL-C, Lp(a) andox-LDL. Its aim is explore the possible pathogenesis mechanismsof homocystein to cause CHD and to provide clinical evidencefor treatment of CHD.Methods :The study group comprised 100 consecutivepatients with CHD in cardiac center of the people, Hospital ofHeBei Province. All of these people has been verified bycoronary angiography. Here are 55 patients in medical treatgroup which add folic aid and vitaminB12 and 45 patients innormal control group who be treat as normal coronary heartdisease patient. Then basing on the concentration of HCY ,wemake some people in subgroup whose HCY over 15μmmol/Land other people in another subgroup whose HCY below 15μmmol/L.Exclusion criteria: acute myocardial infarction within fourweeks, left ventricular ejection fraction<30%, valvular heartdisease, recent operation and injury, renal or liver dysfunction,acute or chronic inflammation, acute leukemia, acutecerebrovasular disease, bronchial asthma, von Willebranddisease, cancer, oral vitamins, lack of estrogen, organtransplantation, self immunity disease.Age, sex, hypertension, diabetes, TG, TC, HDL-C, LDL-C,VLDL-C, smoking and CHD family history in every subjectswere recorded in detail.Blood sampling: Peripheral blood samples were taken onthe second day after the patients came into hospital. Then wetake the blood samples again after 4 weeks,8 weeks and12weeks respectively. Coded samples were stored at -80℃andanalyzed in a single batch for the study, thus, patientmanagement was independent of these results. Levels of HCY,Lp(a)and ox-LDL were measured with ELISA. TG,TC,LDL-Cand HDL-C were measured in lab on the second day after thepatients came into the hospital. Then measured them again after4 weeks,8 weeks and 12weeks respectively.Statistics analysis: SPSS11.0 software pack was used tomake statistical-analysis. Initially the homogeneity of variancebetween all the groups was analyzed. All the numerical data wasshown as mean±standard deviation . students t test and analysisof variance were used to establish significance. LinearCorrelation analysis was used to measure the coefficient ofcorrelation about the correlation data. We took p<0.05 asstatistic signifycance level.Results1 There was no statistical difference between each studied groupabout clinical features . Here are 20 patients with high plasmaHCY in the medical treat group and 15 patients with highplasma HCY in the normal control group. There was nostatistical difference between two studied group with normalplasma HCY concentration about clinical features.2 The comparisons of HCY,TC,TG,LDL-C,HDL-C,Lp(a)and ox-LDL levels in each groups. .2.1 The levels of HCY,TC,TG,LDL-C,HDL-C,Lp(a) andox-LDL were no significantly difference between treatmentgroup and control group.2.2 The levels of HCY was significantly difference in treatmentgroups after 3 months than those before, (15.87±5.50 vs.9.66±2.71 P=0.00),The levels of HCY was not significantlydifference in control groups after 3 months than thosebefore(14.07±8.27 vs. 12.79±4.37 P=0.845), and the level ofHCY in treatment group after 3months was significantlydifference than those in control group(9.66±2.71 vs.12.79±4.37P=0.004)2.3 the levels of TC,TG,LDL-C,HDL-C, Lp(a) were notsignificantly difference in treatment groups and control groupafter 3 months, (TC 3.93±0.99 vs. 4.06±0.93 P=0.747,TG1.57±0.67 vs. 1.52±0.40 P=0.807, LDL-C 2.21±0.75 vs.2.41±0.74 P=0.506, Lp(a) 141.08±182.58 vs. 165.86±133.87P=0.741, HDL-C 1.07±0.20 vs. 0.99±1.05 P=0.250, ),but thereare significantly difference about the level of ox-LDL(10.65±2.02 vs. 12.62±2.40 P=0.009)3 The comparisons of HCY and ox-LDL level in two groupswith normal plasma HCY concentration.3.1 The levels of HCY and ox-LDL were no significantlydifference between treatment group and control group withnormal plasma HCY concentration.3.2 The HCY concentrations of post-treatment were lower thanthose of pre-treatment in treatment group with normal plasmaHCY concentration ,but no statistic significance ( 3moths11.02±4.98 vs. 8.79±3.96 P>0.05),and there was no significantlowering in control group(10.56 ±5.41 vs. 8.96±4.45 P>0.05)3.3 The ox-LDL concentrations of post-treatment were lowerthan those of pre-treatment in both two groups, but there is no...