| Objective:From the point of view of different levels of homocysteine(Hcy),the collected cases were divided into groups according to whether they were combined with hyperhomocysteinemia(HHcy).Differences in general situation,risk factors,biochemical indicators,characteristics of the coronary artery lesion characteristics,and distribution of TCM syndromes between CHD combined with HHcy and CHD without HHcy were analyzed.the relationship between TCM syndrome type and Hcy level and coronary disease was further discussed.In order to provide some reference for the prevention and treatment of CHD combined with HHcy.Method:The patients who were diagnosed as coronary heart disease by coronary angiography in the Department of Cardiology,Oriental Hospital,Beijing University of traditional Chinese medicine from April 2019 to December 2019 were collected.The patients who met the inclusion criteria and exclusion criteria were divided into coronary heart disease with hyperhomocysteinemia group(CHD-HHcy group for short)and coronary heart disease without Hyperhomocysteinemia group(CHD group for short).The patient’s gender,age,height,weight,history of hypertension,history of diabetes,history of abnormal blood lipid metabolism,history of smoking,fanily history,relevant biochemical indicators:Hcy,total cholesterol(TC),Triglycerides(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c),uric acid(UA),and fibrinogen(Fib),and coronary angiography results were collected by pre-made clinical questionnaire.And according to the four diagnosis data of traditional Chinese medicine to carry on the syndrome differentiation.Then all the data were input into Excel database,spss20.0 was used for data statistical analysis,the data accorded with normal distribution,and th e variance was homogeneous.The independent sample t-test was used for the comparison between two groups,and the single factor ANOVA was used for the comparison between multiple groups;the data did not accord with normal distribution,and Wilcoxon rank sum test was used for the difference between two groups,and Kruskal walish rank sum test was used for the comparison between multiple groups.Chi-square test was used for the comparison of counting data sets.Spearman analysis was used for correlation analysis.Results:In this study,215 patients with coronary heart disease were enrolled,including 132 in the CHD-HHcy group and 83 in the CHD group1.General comparison:there was a significant difference in gender between the two groups(P<0.05).The CHD-HHcy group was mostly male,with the proportion of males accounting for 62%greater than that of females accounting for 38%.In the CHD group,the proportion of females was 52%greater than that of males 48%.There was no statistical significance in terms of age and BMI(P>0.05).2.Comparison of risk factors:there was a significant difference in smoking history between the two groups.The proportion of smoking history in the CHD-HHcy group was 56.1%higher than that of non-smoking history(43.9%).The proportion of smoking history in CHD group was 37.3%,and that of non-smoking history was 62.7%.There was no statistical significance in smoking index,history of hypertension,history of diabetes and history.of dyslipidemia(P>0.05).3.Comparison of biochemical indicators:there was no statistically significant difference in TC,TG,LDL-C,HDL-C and Fib between the two groups(P>0.05).In terms of Hcy and UA,blood Hcy and UA in the chd-hhcy group were significantly higher than those in the CHD group,with statistically significant differences(P<0.05).4.Comparison of incidence types:there was a significant difference in incidence types between the two groups(P<0.05).In the CHD-HHcy group,the incidence of acute coronary syndrome(ACS)was more common,and the detection rate of ACS was 83.3%higher than that of SAP(16.7%),while in the CHD group,the detection rate of SAP was 50.6%higher than that of ACS(49.4%).5.The relationship between Hcy level and different factors in general data between the two groups:the blood Hcy level of male patients was significantly higher than that of female patients,and the difference was statistically significant(P<0.05).The blood Hcy level of patients with a history of smoking was significantly higher than that of patients without a history of smoking,and the difference was statistically significant(P<0.05).The blood Hcy level in the ACS group was significantly higher than that in the SAP group,and the difference was statistically significant(P<0.05).6.Comparison of characteristics of coronary artery diseases:there were significant differences between the two groups in the number of coronary artery diseases,classification of coronary stenosis degree and Gensini integral(P<0.05).The number of coronary lesions in CHD combined with HHcy group was mostly multi-branch lesions,and the classification of coronary stenosis was mostly grade 3 and grade 4.The number of coronary artery lesions in CHD group was mostly single branch lesions,and the classification of coronary artery stenosis was mostly grade 3.The Gensini score of CHD-HHcy group was significantly higher than that of CHD group.7.Comparison of the distribution characteristics of TCM syndrome types:there were significant differences in the distribution of TCM syndrome types between the two groups(P<0.05).In CHD-HHcy group,phlegm obstruction of heart and pulse syndrome was the most common,heart blood stasis come second;while in CHD group,qi deficiency and blood stasis were the most common.8.Relationship between TCM syndrome type and blood Hcy level and degree of coronary artery lesions in CHD-HHcy group:there was significant difference in blood Hcy level between different TCM syndrome types in CHD-HHcy group(P<0.05),and the blood Hcy level was higher in phlegm and blood stasis syndrome.There was no significant difference in the number of coronary artery lesions and the grade of coronary artery stenosis between different TCM syndromes in the CHD-HHcy group(P>0.05),but there was significant difference in the Gensini score(P<0.05).The Gensini score of blood stasis syndrome and phlegm syndrome was higher.9.The relationship between the blood Hcy level and the degree of coronary artery lesions in the CHD-HHcy group:the blood Hcy level in the CHD-HHcy group was positively correlated with the number of coronary artery lesions,the grade of coronary stenosis,and the Gensini score.Conclusion:1.CHD patients with HHcy were more male than female,smokers than non-smokers,ACS than SAP;UA level in CHD patients with HHcy was higher than that in CHD patients without HHcy.2.Male gender,smoking,type of incidence and blood Hcy level have certain correlation;Blood Hcy levels were higher in men,smokers and ACS patients.3.The degree of coronary artery disease in CHD patients with HHcy is more serious than that in CHD patients without HHcy.4.The majority of patients with CHD combined with HHcy had phlegm-obstructed heart pulse syndrome and blood stasis syndrome,while the majority of patients without CHD combined with HHcy had qi deficiency and blood stasis syndrome.5.The severity of coronary artery lesions in patients with CHD and HHcy may be related to phlegm and blood stasis.6.The higher the blood Hcy level in patients with CHD combined with HHcy,the more the number of coronary artery lesions,the higher the classification of coronary stenosis,the higher the Gensini score,and the more severe the degree of coronary artery lesions. |
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