| [Objective] Observing the coronary angiography coronary artery lesion severity in patients with coronary heart disease angina pectoris, and study it with the coronary artery blood plasma homocysteine level and related risk factors of coronary artery disease such as systemic arterial pressure level, to improve coronary heart disease diagnosis and provide a scientific basis for prevention and treatment strategies.[Material and Methods] Randomly selected from January2012to January2013because of suspected diagnosis of coronary heart disease angina pectoris patients admitted to the Department of Cardiology of the first Affiliated Hospital of Kunming Medical University, informed consent and the successful implementation of coronary angiography in100patients (64cases of male, female36cases, age84years old, smallest,27years old, average64.15±10.54years old). Including88cases of coronary heart disease(58cases were male,30cases of female age biggest84years old, smallest,27years old, average69.75±11.91years old),55cases with hypertension(34cases were male, female21cases, age80years old, smallest,49,65.38±7.99years on average), do not merge hypertension33cases(men24cases,9cases of women, age84years old, smallest,27years old, average61.58±12.23years old), in the12cases of no coronary heart disease(men6cases,6cases of women, age83years old, smallest,46years old, average69.75±11.91years old), coronary artery normal5cases(men3cases,2cases of women, age81years old, smallest,46years old, average63.00±15.01years old),7cases of coronary artery sclerosis(men3 cases,4cases of women, age83years old, smallest,63years old, average74.57±6.68years old). Collected on admission in patients with hypertension, hyperlipidemia, diabetes, kidney disease, etc, with angiography found at least one branch of coronary artery stenosis degree of50%or more sentence to coronary heart disease; plasma homocysteine levels10μmol/L found to exist high homocysteine levels. All patients were hitches in coronary angiography in coronary artery opening within the coronary artery angiography catheter extraction of4ml of blood specimen, by being future-proof AU400automatic biochemical analyzer and accessory kits plasma homocysteine levels. Observing angiography image parts and severity of coronary artery lesions. Record on admission in patients with age, sex, medical history, smoking history, check the patient’s level of signs, blood lipids, blood pressure. For patients, as appropriate, the implementation of intravascular interventional therapy and/or drug therapy and lifestyle intervention. Using SPSS17.0for Windows statistical software to analyze the observed data, analysis in patients with coronary artery disease severity and blood lipid, blood pressure and the relationship of homocysteine, with p<0.05was considered statistically significant sentence[Results]1. In the preliminary experiments, the mean plasma Hcy of10patients with coronary heart disease and detected in the same period in peripheral vein plasma was no significant difference(16.95±8.503and8.503±8.079,p=0.736).2. Compare with the55cases of merging high blood pressure,33cases of simple coronary heart disease in patients with coronary heart disease, the former coronary artery lesions more3(52.73%and27.27%), the latter single coronary artery pathological changes is more(18.18%and42.43%), p=0.023.3.5cases of coronary normal mean plasma homocysteine than95cases of coronary lesions (11.39±2.18μmol/L and17.27±7.84μmol/L, p=0.001),12cases of coronary heart disease subjects of plasma homocysteine average is less than88cases of patients with coronary heart disease(17.60±7.96μmol/L and11.59±2.770μ mol/L, p=0.011),100cases of coronary artery lesion severity and intravascular blood plasma homocysteine levels are related(r=0.236, p=0.018), that is:the mean plasma homocysteine in coronary coronary artery lesion severity is increasing trend, coronary artery normal group(11.39±2.18μ mol/L)<Coronary atherosclerosis group(13.03±4.68μmol/L)<Single lesion group(15.81±8.34μmol/L)<Double branch lesions in group(16.03±6.68μmol/L)<Three lesions group(16.91±6.02μ mol/L)<Coronary occlusion group(20.31±9.13μmol/L).4.100cases of hypertensive subjects without their grading and intracoronary plasma homocysteine levels positively correlated (r=0.495, P=0.036).100cases of coronary subjects plasma homocysteine levels positively correlated with systolic blood pressure (r=r=0.256, P=0.024), and diastolic blood pressure are positively related(r=r=0.347, P=0.003). Detected high homocysteine levels, hypertension group than non hypertension group(75.56%and87.27%, P=0.632).5. The plasma homocysteine average in mergering hypertension with coronary heart disease patients is higher than that of unincorporated hypertension patients with coronary heart disease, but the difference was not significant (17.76±7.56μmol/L and17.35±8.85μmol/L, p=0.818).6. In the100cases of sample, male, age50or more, smoking, hyperlipidemia, high Hcy levels, at least one factor, such as detection of high blood pressure and/or a higher risk of coronary heart disease(100%and100%, P=1.00), between patients with EH patients and the total factors exist at the same time, the detection risk is higher(r=0.975, P=0.005), patients with CHD patients and total factors exist at the same time, the detection risk is higher(r=1.000, P=0.000<0.05).[Conclusion]1. Peripheral intravenous plasma homocysteine levels can be characterized by intracoronary plasma homocysteine levels, high Hcy levels is an important risk factor for hypertension and coronary heart disease.2. The higher plasma Hey levels in patients with coronary heart disease, the increased blood pressure, the more obvious, the more serious the coronary artery lesions.3. High homocysteine may be increased through the trigger hypertension and elevated blood pressure levels, further participate in the development and progression of coronary heart disease.4. Male, old age, smoking, hyperlipidemia, hypertension, high Hey any item1is the susceptibility factors of coronary heart disease independent or indirectly, at the same time, merge more risk factors, the greater the chance of coronary heart disease patients and crown vein lesions heavier. |
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