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The Values of Plasma Homocysteine, High-sensitivity C-reactive Protein and Carotid Intima Thickness Joint Detection in Patients with Coronary Heart Disease

Author: WangLiJie
Tutor: JiangZhiAn
School: Hebei Medical University
Course: Internal Medicine
Keywords: Homocysteine High-sensitivity C-reactive protein Carotidintimal-medial thickness stable angina pectoris unstable angina pectoris acutemyocardial infarction
CLC: R541.4
Type: Master's thesis
Year: 2013
Downloads: 22
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Abstract


Objective: To detect the plasma concentrations of homocysteine(HCY),high sensitivity C-reactive protein(Hs-CRP)and carotid artery intimal-medialthickness(IMT) in the different types of patients with coronary heart disease,then explore the relationship between these indicators and coronary heartdisease, and obtain Gensini score of coronary artery disease by coronaryangiography, Analysis the correlation between HCY, hs-CRP, IMT andGensini score.Methods: Select patients who underwent coronary angiography and wasdiagnosed with coronary heart disease in the Third Hospital of Hebei MedicalUniversity during November2011and October2012(97cases) as the experi-mental group.These patients include: stable angina pectoris (SAP)40cases,unstable angina pectoris (UAP)32patients and acute myocardial infarction(AMI)25cases. Also select102cases healthy subjects who underwent amedical examination in the Third Hospital of Hebei Medical University for thesame period as a control group. All the objects were ruled out infection, tumor,systemic autoimmune disease, severe liver, kidney disease, and were takingfolic acid, vitamin B6, vitamin B12in three months. All the subjects caughtfasting for12h, then exsanguinate blood samples5mL in anticoagulant tube,and mix in the morning. The blood samples were separated within1hcentrifugation (3500r/min,10min), then get the serum specimens,and excludehemolysis,jaundice and lipemic specimens.Hs-CRP was measured usingShanghai Kehua immune nephelometry and Hcy was measured by circulatingenzymes,both of these were detected at automatic biochemical analyzerOLYMPVS AV5400.Carotid intima thickness were detected by PHILIPSLV22color Doppler ultrasound imaging.The patients of experimental group got Gensini score according coronary angiography, then obtain correlationanalysis of HCY, hs-CRP, IMT and Gensini score.Results:1The comparison of experimental group and the control groupThe plasma concentration of HCY, Hs-CRP and IMT in experimentalgroup were (15.57±5.35)umol/L,(11.57±5.31)mg/L (1.36±0.41)mm, higherthan the control group HCY (9.29±1.43)umol/L, Hs-CRP (2.24±0.61) mg/L,IMT (0.84±0.11)mm, the difference was statistically significant (P<0.05).2Comparison between groups in experimental groupThe groups of SAP, UAP and AMI were compared. HCY,Hs-CRP, IMT,Gensini score by SAP, UAP and AMI show a higher trend in turn. thedifference of HCY, Hs-CRP and Gensini score among the three groups werestatistically significant (P<0.05). The difference of IMT between SAP groupand AMI group was statistically significant (P<0.05), between the other twogroups was not statistically significant (P>0.05).3Grouped by the number of coronary lesionsThe plasma concentration of HCY, Hs-CRP, IMT, Gensini score, from asingle-vessel disease group, two lesions group and three-vessel disease groupin turn show a higher trend, the difference of Gensini score among the threegroups were statistically significant (P<0.05). The difference of HCY, Hs-CRPbetween single vessel disease group and three-vessel disease group wasstatistically significant (P<0.05), but between the other two groups were notstatistically significant (P>0.05); The difference of IMT in single vesseldisease group contrast with two lesions group and single-vessel disease groupcontrast with three-vessel disease group were statistically significant (P<0.05),but between two lesions group and three-vessel disease group was notstatistically significant (P>0.05).4Grouped by the number of carotid artery plaqueThe plasma concentration of HCY, Hs-CRP, IMT, Gensini score, from nocarotid artery plaque group, individual plaques group and multiple plaquegroup in turn show a higher trend, the difference of IMT, Gensini score among the three groups were statistically significant (P<0.05). The difference ofHCY, Hs-CRP in no plaque group contrast with individual plaques group andno plaques group contrast with multiple patches group were statisticallysignificant (P<0.05), but between a single plaque group and multiple patchesgroup was not statistically significant (P>0.05).5Pearson correlation testPearson correlation test: Gensini score and HCY, Hs-CRP and IMT into apositive correlation (r=0.448, P<0.001)(r=0.523, P<0.001)(r=0.342, P<0.01);IMT and HCY, Hs-CRP also into a positive correlation (r=0.307, P<0.01)(r=0.335, P<0.01).HCY and Hs-CRP was positive correlated (r=0.820,P<0.001).Conclusions:1The plasma concentration of HCY, Hs-CRP are closely related to thedegree of risk of coronary heart disease, and they increase with the increase inthe number of coronary lesions.2The plasma concentration of HCY, Hs-CRP and carotid intimal-medialthickness were positive correlated, and they increase with the increase in thequantity of carotid artery plaque.3Carotid intimal-medial thickness and the quantity of carotid arteryplaque can reflect the degree of stenosis of the coronary artery lesions, as wellas the number of diseased vessels indirectly.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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