目的：血浆同型半胱氨酸（Hcy）增高是导致冠心病的独立危险因素。但尚无血浆Hcy与冠状动脉（冠状动脉）支架置入术后再狭窄关系的报道。本研究旨在评价血浆Hcy水平在冠状动脉支架置入术后再狭窄发生中的作用。

方法：选择我院1998年4月至1999年8月所有因接受过冠状动脉支架置入术后3～12个月而进行冠状动脉造影随访复查的患者共76例进行研究。以支架内狭窄≥50％为再狭窄标准，将患者分为再狭窄组（n=40）及非再狭窄组(n=36)。所有患者造影前采取空腹血采用高效液相色谱法（HPLC）测定血浆Hcy水平。

结果：再狭窄组平均血浆Hcy水平与非再狭窄组比较无显著差别（19.45±2.65μmol/L对19.32±2.35 μmol/L,P=0.97)。

结论：血浆Hcy水平与冠状动脉支架置入术后再狭窄发生无明显关系。同时提示支架置入术后再狭窄的发生机制可能与自然冠心病病变者有所不同。

Plasma homocysteine Levels in Restenosis after Elective Coronary Stenting(Abstract)

Division of Coronary heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, beijing (100037)

liu Hai bo, Gao Runlin, Chen Jilin, et al.

objective: Homocysteinemia has been substantiated as a risk factor for coronary heart disease. Few studies have focused on the association between homocysteine (Hcy) and restenosis after coronary angioplasty. The aim of this study was to assess the role of plasma Hcy in restenosis after coronary stenting.

Methods: seventy-six patients who had received elective coronary stenting 3～12 months ago underwent angiographic follow-up in our hospital from April 1998 to august 1999. Instent restenosis was defined as a percent diameter stenosis ≥50% at the site of the lesion treated with the stent in at least one vessel. according to this definition, the patients were divided into two groups: restenosis group (n=40) and nonrestenosis group (n=36). Blood samples for measurement of plasma Hcy were obtained within one week before coronary angiography. Plasma Hcy was measured by high performance liquid chromatography.

Results: mean plasma Hcy level in restenosis group was not significantly different from nonrestenosis group (19.45±2.65 μmol/L vs. 19.32±2.35 μmol/L, p=0.97).

Conclusion: the results suggest that plasma homocysteine does not appear to be significantly associated with risk for restenosis after elective coronary stenting, and the mechanism of restenosis after coronary stenting may be different from that for coronary heart disease.