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目的:探讨血浆中氧化三甲胺（TMAO）水平与早发冠心病的关系。方法:2018年7月2020年7月选取南方医科大学附属深圳宝安医院心脏中心疑诊冠心病患者166例，根据冠状动脉影像学结果（是否确诊冠心病）和发病年龄（≤45岁，>45岁）分为：青年对照组（30例），早发冠心病组（49例），中老年对照组（30例），中老年冠心病组（57例）。检测各组血浆TMAO浓度，分析比较早发冠心病及SYNTAX评分与TMAO的相关性。结果:早发冠心病组血浆TMAO水平［（7.54±2.10）μmol/L］显著高于青年对照组［（4.60±1.89）μmol/L］和中老年冠心病组的［（3.90±1.75）μmol/L］，差异均有统计学意义（n t=6.73，n P?0.001；n t=2.45，n P=0.015）。在早发冠心病组，血浆TMAO水平与SYNTAX评分呈显著正相关（n r=0.66，n P ?0.001），中老年冠心病组血浆TMAO水平与SYNTAX评分呈弱正相关（n r=0.27，n P=0.042）。多因素logistic回归分析显示，血浆TMAO水平与早发冠心病显著关联（n OR=2.30，n P?0.001）。受试者工作特征曲线分析，当血浆TMAO水平取6.08 μmol/L时，诊断早发冠心病效能最佳，敏感度为73.5%，特异度为76.7%。n 结论:血浆TMAO水平与早发冠心病显著相关，具有一定预测价值。“,”Objective:To investigate the associations between plasma trimethylamine-N-oxide (TMAO) level and premature coronary heart disease (PCHD).Methods:From July 2018 to July 2020, total of 166 patients with suspected coronary heart disease were enrolled from the Heart Center of Shenzhen Bao′an Hospital affiliated to Southern Medical University. According to the coronary imaging results and age of onset, they were divided into young control group (n n=30), PCHD group (n n=49), middle-aged and elderly control group (n n=30) and the middle-aged and elderly coronary heart disease group (n n=57). Plasma TMAO concentration in each group was determined by stable isotope liquid chromatography/mass spectrometry, and the correlation of plasma TMAO level with PCHD and SYNTAX score was analyzed.n Results:The plasma TMAO level in PCHD group was significantly higher than that in young control group [(7.54±2.10) μmol/L n vs. (4.60±1.89) μmol/L; n t=6.73, n P?0.001] and middle-aged and elderly coronary heart disease group [(3.90±1.75) μmol/L; n t=2.45, n P=0.015]. The plasma TMAO level was positively correlated with SYNTAX score in PCHD group (n r=0.66, n P?0.001) and in middle-aged and elderly coronary heart disease group (n r=0.27, n P=0.042). Multivariate logistic regression analysis showed that plasma TMAO level was an independent risk factor for PCHD (n OR=2.30, n P?0.001). Receiver operating characteristic (ROC) curve analysis showed that when the cutoff level of plasma TMAO was 6.08 μmol/L, the sensitivity and specificity for diagnosis of PCHD were 73.5% and 76.7%, respectively.n Conclusion:The plasma TMAO level is significantly correlated with PCHD and had certain predictive value for PCHD.