Abstract: Objective: To investigate the relationships between vascular endothelial function, serum homocysteine (Hcy) level and state of coronary heart disease in elderly patients. Methods: 577 elderly coronary heart disease patients were divided into the following groups according to NYHA grade: group Ⅰ(213 patients with cardiac function grade Ⅰ), group Ⅱ (201 patients with cardiac function Ⅱ) and group Ⅲ~Ⅳ (163 patients with cardiac function grade Ⅲ~Ⅳ). 100 healthy elderly persons in the same period were selected as control. The carotid intima-media thickness (IMTc), brachial artery blood flow mediated diastolic function (FMD), serum Hcy level, serum high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) lever of all the human subjects were detected respectively. Results: The IMTc and Hcy of patients in 3 coronary heart disease groups were obviously higher than control, the FMD was obviously lower (P<0.05). There was no significantly statistical differences in serum HDL-C and LDL-C level between all the subjects (P>0.05). In coronary heart disease groups, the IMTc and Hcy gradually increased, FMD gradually decreased with increasing of cardiac function classification (P<0.05). Conclusions: The severity of coronary heart disease in elderly patients is related to vascular endothelial function and serum Hcy level.

Key words: Elderly, Coronary heart disease, Homocysteine, Vascular endothelial function

摘要： 目的:探讨血管内皮功能与血清同型半胱氨酸（Hcy）水平与老年冠心病患者病情的关系。方法:577例老年冠心病患者根据美国纽约心脏病协会(NYHA)心功能标准分组,Ⅰ组（心功能Ⅰ级患者213例）、Ⅱ组（心功能Ⅱ级患者201例）,Ⅲ~Ⅳ组（心功能Ⅲ~Ⅳ级患者163例）;选取同期100例老年健康体检者作为对照组。分别检测各组受试者的颈动脉内膜中层厚度（IMTc）、肱动脉血流介导的舒张功能（FMD）,血清Hcy、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的水平。结果:冠心病各组IMTc、血清Hcy水平明显高于对照组,FMD明显低于对照组,差异具有统计学意义（P<0.05）;各组受试者血清HDL-C和LDL-C水平比较差异无统计学意义（P>0.05）。冠心病各组间比较,随着心功能分级的升高,IMTc和Hcy逐渐升高、FMD逐渐降低,两两比较差异具有统计学意义（P<0.05）。结论:老年冠心病患者病情的严重程度与血管内皮功能和血清Hcy水平有关。

关键词: 老年, 冠心病, 同型半胱氨酸, 血管内皮功能