The Correlation Of HCY,HDL,PON And The Degree Of Coronary Lesions In Patients With CHD

Objective:To study the correlation of homocysteine(HCY),HDL and paraoxonase(PON)in patients with coronary heart disease(CHD).To investigate whether the HCY by changing oxygen phosphorus enzymes affect HDL normal function and increase the occurrence of CHD,and then found the clinical application value of the PON in coronary heart disease coronary artery lesion severity evaluation.Methods:The patients of the Second Clinical Hospital of Shanxi Medical University were randomly selected from February 2017 to August 2017,coronary angiography of 211cases of patients,according to the result of coronary angiography group coronary heart disease 125(CHD)and normal coronary artery in the control group 86(NC).Record each general information mainly includes:age,sex,body mass index,smoking history,drinking history,family history of hypertension,diabetes and coronary heart disease,early the next morning fasting venous blood was extracted to determine the blood sugar,blood lipid,renal function and biochemical test results,simultaneous determination between groups homocysteine levels and levels of paraoxonase.record the results of coronary angiography coronary lesion counts.The degree of coronary artery lesions was evaluated by Gensini scoring system,and the levels of PON1 and PON3 were determined by enzyme-linked immunosorbent assay.Count according to the result of the CAG involvement of coronary lesions and the area is divided into single lesion group 68cases,more than double the lesion group 20 cases,(3)or higher lesion group of 37 cases with left anterior descending branch(LAD)in 62 cases,left circumflex(LCX),38 cases,25 cases of right coronary artery(RCX),it according to different coronary artery lesion severity is divided into three subgroups:mild lesion group(0<Gensini score 12 or less)45 cases,moderate lesion group(12<Gensini score 32)or less group 30 cases,severe lesions(Gensini score 32 or higher)in 48 patients.According to the height of HCY,it is divided into three grades:low,medium and high(low:15-30 mol/L),medium:30-100mol/L,and high:HCY>100 mol/L.Among them,there were 60 cases of low degree,40cases of moderate degree and 25 cases of severe degree.The general situation and blood lipid level of the patients were compared in groups,and the HCY,HDL and PON levels of the coronary heart disease group and the normal coronary artery control group were compared.The relationship between the HCY score,the number of different coronary lesion branches and the severity of coronary lesions was analyzed,and the correlation between HCY and HDL,HCY and PON1 and PON3 was analyzed.SPSS20.0 software was used for data entry and processing of the above data,and SAS was used for data analysis.Results:1.Comparison of general data and blood lipid between the coronary heart disease group and the normal coronary control group.There is no significant difference and comparability,as follows:age of CHD group(59.41±9.9 years old,57.93±9.57 years old),TG(1.53±0.96mmol/L,1.46±0.78mmol/L),LDL(2.29±0.76mmol/L,1.60±0.64mmol/L),LP-α(21.22±1.85mmol/L,17.12±17.92mmol/L),CHOL(3.28±3.94mmol/L,2.56±1.62mmol/L),apoB-100(0.87±0.42mmol/L,0.72±0.35mmol/L),apoA-1(1.05±1.87mmol/L,0.92±0.41mmol/L).The levels of Scr(70.20±15.48umol/L,68.407umol/L,321.5±103.27umol/L)w5±12.92umol/L),BUN(4.93±1.44mmol/L,4.87±1.52mmol/L)and uric acid(329.36±78.ere higher than those of the normal control group.Body mass index(23.59±6.98kg/m~2,24.24±5.28kg/m~2),FPG(4.95±1.26mmol/L,5.05±1.18mmol/L),HDL(1.56±0.72mmol/L,1.74±0.78mmol/L)were lower than NC group.In the two groups,except apob-100 and LDL P<0.05,there was a statistical difference,and all other indicators were comparable,but there was no statistical significance.2.Comparison of HCY,HDL and PON levels between the CHD group and the normal control group:(1)Compared with the normal control group,the HCY level of the CHD group was higher than that of the CHD group[14.2μmol/L vs 13.2μmol/L,P=0.0058].(2)There was no statistically significant difference in HDL content between the CHD group and the control group[1.480 mmol/L vs.1.535 mmol/L,P=0.0893].(3)Compared with the normal control group,PON1 activity was significantly decreased in the CHD group[(410.4±68.4)U/ml vs(1000.5±78.1)U/ml,P=0.006].(4)compared with the normal control group,PON3 activity was significantly decreased in the CHD group[(521.4±49.4)U/ml vs(2020.5±65.3)U/ml,P=0.018].3.Correlation analysis of HCY score and degree of coronary artery disease:(1)among patients with coronary heart disease,the score of Gensini in the HCY increased group was higher than that in the normal HCY group[(33±12)vs(24±3.5),P<0.001].(2)HCY level has a positive correlation with single,double and multiple coronary artery lesions,with a correlation coefficient of 0.192,P=0.046.That is,the higher the patient’s Hcy content,the more serious the degree of coronary artery lesions.4.Correlation analysis of HCY with HDL,PON1 and PON3 in patients with coronary heart disease:(1)HCY is negatively correlated with HDL with a correlation coefficient of-0.18,P=0.0438.(2)in the CHD group,HCY was negatively correlated with PON1,and the correlation coefficient was-0.458,P=0.0029.(3)there was a negative correlation between HCY and PON3 in the CHD group,and the correlation coefficient was-0.412,P=0.03.Conclusion:1.Patients with coronary heart disease(CHD)HCY levels significantly higher than the normal control group,the coronary artery and with the increase of HCY levels,gradually increased coronary lesion degree and the lesion counts,further confirmed that HCY is aggravating development important independent risk factor for coronary heart disease.It provides a strong basis for the control of clinical risk factors of coronary heart disease.2.Compared with normal control group,CHD group HDL levels,no statistical difference shows that HCY is not necessarily by lowering HDL levels lead to the occurrence of coronary heart disease,but affect HDL normal function play a role in the occurrence of atherosclerosis.3.In patients with coronary heart disease(CHD),HCY and negatively correlated with HDL,PON1,PON3 concentration,combination of PON activity significantly decreased compared with normal control group,CHD group prompted even normal HDL levels,HCY may still by lowering the oxygen phosphorus enzymes affect HDL function accelerates the process of coronary heart disease(CHD).