| Objective: The coronary artery disease is more popular disease that threatens people,s life and health,and is a major reason of death in elderly patients. The morbidity and mortality of the coronary artery disease is increasing with age. The risk factors include hypertension, hyperlipoproteinmia, diabetes, smoking cigarettes etc. Recently,many studies have shown that the increase of plasma homocysteine(HCY) is an independent risk factor for atherosclerosis,and the vascular endothelial dysfunction is the original factor. An early feature of atherosclerosis is damage to the endothelium, and changes in endothelial function will occur before the structural changes can be detected. But the relationships of atherosclerosis and endothelial function and plasma homocysteine level are known little. The aim of the present study is to evaluate the relationship of plasma homocysteine level and endothelium-dependent dilatation in elderly patients with coronary artery disease.Methods: Sixty-three patients with coronary arterydisease except diabetes were selected, age 60-82years, including male 53, female 10, average age 71.33±5.48years. Among them, there are 27 with old myocardial infarction,21 with stable angina, 15 with acute coronary syndrome.The following conditions were excluded: severe hepatic and renal dysfunction, malnutrition,malignant tumour, malignant anemia,diabetes. The coronary artery disease defined by the World Health Organization in 1979.All the patient accepted the regular medicine before blood samples were taken.The patient avoided eating food rich of protein for three days and fasting for 12 hours before the blood samples were obtained at 7:00-8:00 in the morning, and had laid on bed for 15 minutes at least, 2ml of the blood samples were taken from median antebrachial vein, put into the heparinized tubles, then centrifugating by 1500/minute for 10 minutes,obtained the plasma from the blood, the plasma sample were kept in -72℃ refrigerator, ELISA method was used to determine the homcysteine level. The biochemistry blood sample(4ml) were taken from vein, obtained the serum from the blood and determined in the same day.The vascular endothelium-dependent dilatation function was evaluated by Celermajer,s method. Brachial artery was selected as target artery. We used the American 2500 type colourful high resolution ultrasound with 7.5MHz high frequency linear array transducer to measure the diameter of brachial arteries at rest, during reactive hyperemia (withincreased flow causing endothelium-dependent dilation) and after sublingual nitroglycerin (causing endothelium-independent dilation), respectively.The transducer was kept on the same place and the diameters of brachial arteries were measured on the same place during the measurement.All the data were used SPSS10.0 software pack to make statisticalanalysis. Initially the homogeneity of variance between all the groups was analyzed. All the measurement data was denoted by mean±standard deviation and students t test was used to establish significance. ANOVA was used to compare the difference between the groups.Chi-square test was used to compare Enumeration data about difference of rate between the groups. Correlation test was used to measure the coefficient of correlation about the correlation data. We take p＜0.05 as statistic significance level. Result: 1. All the patients were divided into groups of normal plasma HCY level(≤15.00μmol/L)and high plasma HCY level(＞15.00μmol/L), There were no significant differences in any of the age ,total cholesterol, low- density lipoprotein, hypertension between the two groups .The data of the two groups were well-balanced. and comparable with each other.(Table 1)2. There were 41 patients of normal plasma HCY level, the plasma HCY level was 9.83±2.96μmol/L; and 22 patients of high plasma HCY level, the plasma HCY levelwas20.11±6.27μmol/L.Among them,the plasma HCY level of stable angina was11.14±4.27μmol/L,old myocardial infarction was12.03±6.29μmol/L,acute...
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