بررسي ارتباط بين سطح سرمي هموسيستئين و ليپوپروتئين (a) با ابتلا به بيماري‌هاي قلبي

Evaluation of Sera Hemocystein and Lipoprotein (a) levels in relation to other risk factors of cardiovascular diseases

مقدمه: همگام با پيشرفت تكنولوژي‌هاي پيشرفته پزشكي و روش‌هاي تشخيصي درماني بيماران قلبي، عوامل خطر جديدي در اتيولوژي بيماري‌هاي قلبي- عروقي مطرح مي‌شود. هموسيستئين، ليپوپروتئين (a)، قيبرينوژن و فاكتور هفت از جمله عوامل خطر جديد بيماري‌هاي قلبي- عروقي هستند كه توجه پژوهشگران را به خود جلب نمودند. هدف از اين مطالعه موردي- شاهدي بررسي ميزان هموسيستئين در بيماران قلبي بستري در بيمارستان شهيد مصطفي خميني در شهر ايلام و مقايسه آن با افراد گروه شاهد است. روش‌ها: در اين مطالعه موردي- شاهدي، افراد گروه مورد را بيماران قلبي بستري در بخش قلب (40=n) بيمارستان شهيد مصطفي خميني ايلام و افراد گروه شاهد (60=n) را كساني تشكيل دادند كه بدون هيچ‌گونه سابقه بيماري قلبي در اين بيمارستان براي منظور‌هاي ديگري غير از بيماري‌هاي قلبي بستري شدند. پس از كسب رضايت كتبي از كليه نمونه‌ها 8 سي‌سي نمونه خون ناشتا جهت بررسي هموسيستئين، قند خون ناشتا (FBS) كلسترول، تري گليسريد، LDL و HDL گرفته شد. داده‌هاي دموگرافيك و باليني با استفاده از يك پرسش‌نامه استاندارد جمع‌آوري گرديد. يافته‌ها: بيش از نيمي از افراد گروه مورد (52/5 درصد) زن و بيش از يك سوم افراد گروه شاهد (36/6 درصد) مرد بودند. ميانگين سني و انحراف معيار افراد گروه مورد و شاهد به ترتيب 10/27 ± 49/48 و 13/03 ± 42/25 سال بود(0/05

Background: In addition to the known risk factors of cardiovascular diseases, many studies reported that there are some new risk factors such as Hemocystein, lipoprotein (a), fibrinogen and factor VП affecting the morbidity and increasing the risk of disease. The current study was designed to evaluate such risk factors in relation to those previously established in a case-control study design. Methods: 40 patients with heart disease among those admitted to Shahid Mustafa Khomeini Hospital in Ilam were randomly selected as case while 60 healthy people who had no sign of heart disease as the control group. A questionnaire including some demographic and clinical questions was completed for each individual, prior to blood sample to be taken after a written consent was taken from each patient. From each individual in case and control group 8 ml blood was taken and the sera were extracted. FBS, LDL, HDL, TG, cholesterol, lipoprotein (a) and Hemocystein all were measured using a BT 3000 Auto Analyser in Ebne Sina lab in Ilam. Findings: The mean age of case and control groups was 49.48 ± 10.37 and 42.25 ± 13.03 years, respectively. The mean sera Hemocystein level was 13.51 ± 3 and 13.42 ± 3 in case and control groups, respectively with no significant difference. Individuals in case group had increased their sera levels of LDL, TG, and cholesterol much more than those for control group. The sera Hemocystein level also increased with increase of age in both groups with significant correlation for the case group (P < 0.006). Conclusion: Although the Hemocystein level increased with increase of age which can be interpreted as a risk of increasing the possibility of cardiovascular disease, the correlation of Hemocystein in case and control groups was not significant. There was a significant correlation between HDL and Hemocystein but the results showed that Hemocystein is not as effective as other risk factors such as LDL, TG and cholesterol in prevalence and severity of disease. It is suggested that some more studies with broader spectrum in sample size and risk factors be designed in order to evaluate such a correlation in more details.