主动脉夹层和主动脉瘤与高血浆同型半胱氨酸

Hyperhomocysteinemiain Patients with Aortic Dissection and Aortic Aneurysm

目的观察主动脉夹层及主动脉瘤患者血浆同型半胱氨酸(Hcy)的水平。方法病例组为确诊的106例主动脉夹层患者及38例主动脉瘤患者,对照组为199例在性别、高血压病史、饮酒史等与病例组相匹配的门诊查体者。常规检测血生化指标,高效液相方法测定血浆同型半胱氨酸。结果主动脉夹层合并主动脉瘤组血浆Hcy水平较对照组增高,分别为(19.75±12.77)μmol/L和(13.43±5.15)μmol/L,(P<0.001),病例组高血浆同型半胱氨酸患者的比率高于对照组,分别为67.4%和38.5%(P<0.01)。主动脉夹层组血浆Hcy水平较主动脉瘤组稍高,分别为(20.25±13.96)μmol/L和(18.76±8.55)μmol/L,但差异不显著。主动脉夹层急性期与慢性期组的血浆Hcy水平无差别。将病例组按性别分层后,血浆Hcy水平与对照组相比,仅女性主动脉瘤组无差异,其余各组均显著增高(P<0.01或P<0.05)。结论主动脉夹层合并主动脉瘤组血浆Hcy水平较对照组增高,高血浆Hcy与主动脉夹层合并主动脉瘤的发生、发展密切相关。

ObjectiveTo investigate plasma homocysteine plasma level in patients with aortic dissection and aortic aneurysm.MethodOne hundred and six patients with aortic dissection and 38 patients with aortic aneurysm were enrolled. All patients were diagnosed by ultrafast computer tomography.One hundred ninety-nine gender and age-matched subjects (age range, 50-78 years) were served as control.Plasma homocysteine (Hcy) was determined by high-performance liquid chromatography.Results 67.4% of the patients with aortic dissection and aortic aneurysm had high plasma Hcy, while only 38.5% in control.Homocysteine plasma levels were significantly higher in this cohort of patients than in control subjects (19.75±12.77)μmol/L vs (13.43±5.15)μmol/L; P<0.001).Plasma homocysteine in patients with aortic dissection was of little difference from that in patients with aortic aneurysm(20.25±13.96)μmol/L vs (18.76±8.55)μmol/L, (P>0.05), and no difference was found between patients with acute and chronic aortic dissection.When both the patients group and control group were categorized by sex, plasma homocysteine level of both female and male subgroups were significantly higher than the respective control subgroup.ConclusionOur data indicate that there are high plasma homocysteine level in patients with aortic dissection and aortic aneurysm.Hyperhomocysteine may involve in the pathogenesis of aortic dissection and aortic aneurysm.