The Research On Correlation Analysis Of Homocysteine And Total Bilirubin Levels With Carotid Atherosclerosis In Elderly Patients With Coronary Atherosclerosis Heart Disease

Background and ObjectiveCoronary atherosclerotic heart disease(Coronary atherosclerotic heart diseases,CHD),called coronary heart disease for short,which is the most common type of common chronic disease that harms the health of elderly,In recent years,the percentage about elderly patients with coronary atherosclerosis heart disease of all disease is on the rise with the great changes of modem living conditions,the increase of cardiovascular risk factors and the intensification of aging in China,and the mortality rate of cardiovascular disease is in the first place.Coronary atherosclerosis is one of the important risk factors leading to cardiovascular events,especially,as the function of all organs and systems of body declines with age,the development process of coronary atherosclerosis has been noticeably accelerated.But it is not clear that the pathogenesis and key factors are responsible for acceleration the process of coronary atherosclerosis,which is a field that need to be in-depth research.So far a lot of investigation and study indicate that plasma homocysteine(HCY)levels,or serum total bilirubin(TBIL)level are closely related to the degree of the cardiovascular disease.The results of clinical research shows that the increase of HCY levels or the decrease of TBIL levels contribute to the increase of the incidence on coronary heart disease.carotid artery Intima-media thickness(IMT)can be used as a important measure of the evaluation and diagnosis of the degrees of coronary atherosclerosis.There is few studies from both home and abroad on the relationship of HCY levels and TBIL levels with coronary atherosclerosis,therefore The purpose of this paper is to investiate the correlation between the levels of HCY,TBIL and carotid athrosclerosis in elderly patients with coronary atherosclerosis heart diseas,which can early predict the occurrence risk of coronary heart disease and provide reliable and simple method to for early clinical intervention.MethodA sum of 161 cases of elderly patients with CHD from our hospital were enrolled as research object.According to the diagnostic criteria from guidelines for the diagnosis and treatment of stable coronary heart disease in China,involving clinical manifestation,dynamic electrocardiogram,computerized tomography angiography(CTA)and coronary angiography,all subjects under our research were divided into two groups:CHD group(n=90)and No CHD group(n=71),The general data including sex,age,weight,height,body mass index(BMI)and smoking history of the two groups are carefully inquired and recdorded,blood samples were collected from all subjects,the related biochemical indexes of plasma homocysteine(HCY),serum total bilirubin(TBIL)alow density lipoprotein(LDL-C),high density lipoprotein(HDL-C),total cholesterol(TC),creatinine(Cr),fasting blood glucose(FPG),urea nitrogen(BUN),triglyceride(TG)and uric acid(UA)levels of all blood samples are examined by an automatic biochemical analyzer,carotid artery intima-media thickness(IMT)was detected by color ultrasonic examination of PHILIPS EPIQ 7C device.The general data including sex,age,weight,height,body mass index(BMI)and smoking history of the two groups are strictly screened and analyzed.the statistical methods is used to determine whether the significant difference of general data including sex,age,weight,height,body mass index(BMI)and smoking history and the test indexes about serum HCY,TBIL,LDL-C,HDL-C,TC,Cr,FPG,BUN,TG and UA levels of CHD group vary significantly from No CHD group.The correlation between the relevant biochemical indexes of serum(HCY,TBIL,LDL-C,HDL-C,TC,Cr,FPG,BUN,TG and UA)levels and IMT are explored by correlational analysis with Pearson method.The key factors of influences on the thickness of carotid IMT in elderly patients with coronary heart are recognized and quantitatively described by the multivariate linear stepwise regression analysis of SPSS commercial software.ResultsNo significant difference exists in general information about sex,age,weight,height,BMI and smoking history,other biochemical indexes of LDL-C,HDL-C,TG,UA,Cr,BUN,FPG and TC levels between two groups(P>0.05).But,the statistical analysis indicate that the average of HCY and IMT levels are obviously higher in CHD group than in No CHD group(P<0.05),and the average of TBIL level is dramatically lower(P<0.05).As can be seen from the correlation analysis chart in our paper,it can be found that a positive correlation between HCY level and carotid IMT level in elderly CHD patients(correlation coefficients R2=0.9007,P=0.036),and a negative relationship between TBIL level and carotid IMT level in elderly CHD patients(correlation coefficients R2=0.8744,P=0.028);The quantitative relation of the increase of HCY level or the decrease of TBIL level with the increase of carotid IMT thickness can be defined by the result of multivariate linear stepwise regression analysis.When plasma HCY levels of CHD patients increase by 10 mol/L,the thickness of carotid IMT can increase by 0.53 mm;If serum TBIL levels of CHD patients decrease by 10 mol/L,the thickness of carotid IMT can increase by 0.23 mm.Conclusion(1)The serum HCY levels and TBIL levels are closely associated with the thickness of carotid IMT of CHD elderly patients,and serum HCY level is positively correlated with carotid IMT level in elderly CHD patients,but TBIL level is negativly correlation with carotid IMT level in elderly CHD patients.(2)The increase of serum HCY levels or TBIL levels is a clear sign of the prediction on the incidence of the cardiovascular diseases event in the elderly.