| Object: Coronary heart disease(CHD)has been one of themajor fatal diseases threatening people's lives in the world. Theincidence and mortality of CHD are increasing gradually.Atherosclerosis(AS) is its pathologic basis . Its pathologicmechanisms include dysfunction of endothelium, smooth musclecell proliferation, blood platelet activation and thrombosisformation. So the prevention and intervention of AS havebecome an important target of clinical study. Reserches in recentyears have indicated that hyperhomo-cysteinemia(HHcy) isemerging as an independent AS risk factor other thanconventional risk factors such as smoking, sex, age, hypertension,diabetes mellitus and dyslipidemia. The relationship ofhomocysteine (Hcy),Nitric oxide(NO) and von WillebrandFactor(vWF) with AS has been elucidated, but no study on therelationship of Hcy changes with NO and vWF has been reported.It is known that HHcy is associated with folate deficiency. Theaim of this study is to explore the effects of folic acid andvitaminB12 on the concentrations of fasting Hcy , NO andvWF in patients with coronary heart disease and theirrelationship in these patients.Methods: From a cohort of 262 patients admitted withCHD who underwent coronary angiography (CAG) orintravascular ultrasound(IVUS) in cardiac center of the people,sHospital of HeBei Province and Cangzhou Central Hospital.They were randomly divided into two groups. Patients in studygroup (135cases) were given folic acid(5mg/d) andvitaminB12(250ug/d) orally in addition to routine treatment, andpatients in control group (127cases) were treated with routinetreatment.In this study , 87 patients who have HHcy ( ≥15umol/L) were selected from 262 patients, study group (46cases)and control group(41cases).Patients with the following conditions were excluded in ourstudy: within four weeks after acute myocardial infarction, leftventricular ejection fraction<30%, valvular heart disease,hypertension above grade 2 , diabetes mellitus , recentoperation and injury , acute or chronic inflammation, renal orliver dysfunction, cancer, autoimmune disease, acutecerebrovasular disease, acute leukemia, bronchial asthma, organtransplantation, oral vitamins, lack of estrogen, von Willebranddisease. Age, sex, hypertension, TG, TC, HDL-C, LDL-C,smoking and family history of CHD of every subjects wererecorded in detail.Routine treatments include Enteric coatedaspirin(75mg qd),Simvastatin (20mg qd) and Dinitrosorbide(10mg tid).Blood sampling and Laboratory assays: Peripheral bloodsamples were taken and coded respectively. The coded sampleswere stored at -80℃and analyzed in a single batch for the study.The blood samples of the two groups were assayed pre-andpost treatment (baseline,1 month,2 months,3 months later), andthe concentrations of Hcy , NO and vWF were measured.ELISA was used to assay the levels of Hcy,NO and vWF.CAG : CAG was performed by Judkin's way throughfemoral or radial artery. The stenosis of coronary artery wasmeasured by the diameter . Stenosis>50% was defined assignificant lesion and if necessary confirmed by IVUS .Statistics analysis: SPSS11.0 software pack was used fordata analysis. Initially the homogeneity of variance between allthe groups was analyzed. All the numerical data were expressedas mean±standard deviation and students t test or analysis ofvariance(ANOVA) and LSD-t test were used for statistical test.Chi-square test was used for analysis of categorical data. LinearCorrelation analysis was used to measure the coefficient ofcorrelation about the correlation data. P<0.05 was considered asstatistic significance.Result:1 There was no statistical significant difference among eachstudied group in general clinical features(P>0.05) .2 The Hcy and vWF concentrations of post treatment weresignificantly lower than those of pre-treatment in theatedgroup(p<0.01),and there were no significant changes in thecontrol group (P>0.05) .3 The NO levels of post treatment were higher than thoseof pre-treatment in theated group(p<0.01), and there were no...
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