高同型半胱氨酸血症与慢性阻塞性肺疾病急性加重期血栓形成的相关性研究进展

Research progress on the correlation between hyperhomocysteinemia and thrombosis in acute exacerbation of chronic obstructive pulmonary disease

慢性阻塞性肺疾病急性加重期(AECOPD)是指呼吸道典型症状的恶化或合并心力衰竭、骨质疏松症、肺栓塞等并发症。AECOPD合并静脉血栓栓塞症(VTE)发生率较高,因此AECOPD患者尽早发现静脉血栓形成尤为重要。血浆D-二聚体是排除血栓的主要生物标志物,但其特异性和阳性预测值较低,临床亟需易于获得的新生物标志物来增加血栓检出率。同型半胱氨酸(Hcy)是蛋氨酸分解过程的代谢产物,高同型半胱氨酸血症(HHcy)可能是AECOPD患者血栓形成的潜在危险因素。因此,本综述从致病机制方面阐述HHcy与AECOPD血栓形成的相关性,以期为临床研究及治疗提供理论认知及基础。

Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is the deterioration of typical respiratory symptoms or the emergence of complications such as heart failure,osteoporosis,and pulmonary embolism.The patients with AECOPD have high incidence of venous thrombo embolism(VTE).Therefore,early detection of venous thrombosis during AECOPD is particularly important.Plasma D-dimer is the main biomarker for excluding thrombosis in clinical practice,but it has low specificity and positive predictive value,and new biomarkers that are easily available are needed to identify and increase the detection rate of thrombosis.Homocysteine is a metabolite of methionine decomposition,and hyperhomocysteinemia(HHcy)may be a potential risk factor for thrombosis in patients with AECOPD.Therefore,this paper reviews the correlation between HHcy and thrombosis in AECOPD from the perspective of pathogenic mechanism,in order to provide theoretical knowledge and basis for clinical research and treatment.