高同型半胱氨酸血症与外周血管疾病相关性的研究进展

Research progress on the correlation between hyperhomocysteinemia and peripheral vascular diseases

同型半胱氨酸(Hcy)是一种含硫的氨基酸,其代谢受多种酶、辅酶、生理及病理因素的影响,当Hcy水平≥15μmol/L时,则诊断为高同型半胱氨酸血症(HHcy)。HHcy除了与心脑血管疾病的发生、发展密切相关之外,还与主动脉疾病、外周动脉疾病(PAD)、静脉血栓栓塞症(VTE)和下肢慢性静脉功能不全(CVI)等外周血管疾病有关。它主要可能是通过氧化应激反应、脂类代谢障碍、对基因转录产生改变等多种机制导致血管内皮损伤而引起。除此之外,Hcy代谢过程中多种酶的缺陷亦与血管疾病的发生有一定的关联。本文重点阐述Hcy的代谢途径、HHcy发生的危险因素、HHcy的致病机制以及HHcy与外周血管疾病相关性的研究进展。

Homocysteine(Hcy)is a sulfur containing amino acid,its metabolism is affected by a variety of enzymes,coenzymes and physiological and pathological factors.When the level of Hcy is≥15μmol/L,it is diagnosed as hyperhomocysteinemia(HHcy).HHcy is not only closely related to the occurrence and progression of cardiovascular and cerebrovascular diseases,but also related to peripheral vascular diseases,such as aortic disease,peripheral arterial disease(PAD),venous thromboembolism(VTE),and lower extremity chronic venous insufficiency(CVI).It may be mainly caused by oxidative stress response,lipid metabolism disorders,gene transcription changes and other mechanisms leading to vascular endothelial injury.In addition,the defects of various enzymes in the metabolism of Hcy are also correlated with vascular diseases.This article will focus on the metabolic pathways of Hcy,risk factors for HHcy,pathogenic mechanisms of HHcy,and research progress on the correlation between HHcy and peripheral vascular diseases.