| Objective: To investigate the correlation between plasma levels of homocysteine(HCY),folic acid(FA)and vitamin B12(Vit B12)and Gensini score reflecting the severity of coronary artery disease(CHD)by analyzing the characteristics of plasma levels of HCY,FA and VitB12 in patients with coronary heart disease(CHD).Methods: The clinical data and plasma of 250 patients with chest tightness and chest pain who underwent coronary angiography in the Department of Cardiovascular Medicine,First Affiliated Hospital of Bengbu Medical College from December 2017 to November 2018 were collected.According to the results of clinical diagnosis and coronary angiography,250 patients were divided into four groups: 74 cases in AMI group,104 cases in UAP group,39 cases in coronary sclerosis group and 33 cases in normal coronary artery group.The clinical data and plasma of 50 healthy subjects were collected as healthy control group.The plasma levels of HCY,FA,Vit B12,TC,TG,HDL,LDL,Apo A and Apo B were measured,and the correlation of general data was analyzed by chi-square test;the correlation of HCY,FA,Vit B12 and biochemical indexes with CHD was analyzed by one-way ANOVA,and the correlation between the two groups was also analyzed;the confounding elements were excluded by one-way regression analysis,and then the two-way logistic regression was used.Risk factors of CHD were analyzed and ROC curve was used to evaluate the ability of HCY,FA and Vit B12 to diagnose CHD.Meanwhile,according to the results of coronary angiography,the patients with coronary stenosis were divided into three groups by Gensini score: 75 cases in < 20 group,72 cases in 20-50 group and 70 cases in > 50 group.The correlation of HCY,FA,Vit B12 and biochemical indexes with Gensini score was analyzed by Spearman correlation.Results:(1)The proportion of male in UAP group was significantly higher than that in coronary atherosclerosis group and healthy control group(P < 0.05);the proportion of hypertension in UAP group,AMI group and coronary atherosclerosis group was higher than that in healthy control group(P < 0.05);(2)HCY level in AMI group,coronary atherosclerosis group and UAP group was significantly higher than that in normal coronary artery group(P < 0.05);HCY level in AMI group and UAP group was significantly higher than that in normal coronary artery group(P < 0.05);HCY level in AMI group and UAP group was significantly higher In coronary atherosclerosis group(P < 0.05),HCY level in AMI group was significantly higher than that in UAP group(P < 0.05);FA level in AMI group,UAP group and coronary atherosclerosis group was significantly lower than that in healthy control group(P <0.05);Vit B12 level in coronary atherosclerosis group,normal coronary artery group,AMI group and UAP group was significantly lower than that in healthy control group(P < 0.05);(3)Gender,hypertension and HCY were risk factors for CHD(P < 0.05);HDL was protective factor for coronary heart disease(OR = 0.05).16,P < 0.05);(4)The area under ROC curve for HCY diagnosis of coronary heart disease was 0.728,sensitivity was 71.9%,specificity was 66.6%,and the optimal threshold value was10.95 mmol/L;(5)FA level was weakly negatively correlated with Gensini score(r=-0.246,P=0.000),Apo A was weakly negatively correlated with Gensini score(r=-0.214,P<0.05),and HCY was weakly positively correlated with Gensini score(r=0.321,P=0.000).Conclusion: 1.The level of HCY in CHD patients increases,HCY is a potential index to judge the severity of coronary artery disease;2.FA level in CHD patients decreases,FA is a potential index to judge the severity of coronary artery disease;3.Vit B12 level in CHD patients decreases,but Vit B12 is not related to the severity of coronary artery disease. |
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