血浆同型半胱氨酸水平和主动脉夹层的关系

目的：探讨血浆同型半胱氨酸水平和主动脉夹层的关系。方法回顾性分析2011年10月至2013年1月符合纳入标准的111例受试者。急性主动脉夹层组（A组）45例，平均年龄（57.62±9.74）岁，其中男35名，女10名；非急性主动脉夹层组（B组）16例，平均年龄（53.88±8.12）岁，其中男12名，女4名，对照组为50例同期体检者（C组），平均年龄（55.62±4.07）岁，其中男41名，女9名。常规检测血生化指标，运用循环酶法测定血浆同型半胱氨酸水平。结果三组血浆Hcy水平分别为（17.85±8.65）μmol/L，（22.15±10.45）μmol/L和（12.74±3.32）μmol/L（P＜0.001），高同型半胱氨酸血症发生率三组分别为57.8%，68.8%和30.0%（P＜0.001）。多元Logistic回归分析显示高同型半胱氨酸血症（HHcy）较非HHcy发生AD的风险增加（OR＝4.39；95% CI＝1.57，12.28；P＜0.01）。经相关危险因素调整后，未明显改变相关结果（OR＝4.78；95%CI＝1.21，18.92；P＜0.05）。结论夹层组HHcy发生率高于健康对照组，血浆Hcy水平较对照组增高，高同型半胱氨酸血症可能是主动脉夹层的独立危险因素，需要更多的研究予以证实。

The relationship between plasma homocysteine and aortic dissection

Objective To study the relationship between plasma homocysteine and aortic dissection. Methods From October 2011 to January 2013, a total of 111 participants met the inclusion criteria including 45 acute aortic dissection patients [group A, mean age （57.62_9.74）years, 35 males], 16 non-acute aortic dissection patients[group B, mean age （53.88±8.12）years, 12 males] and 50 healthy controls[group C, mean age （55.62±4.07）years, 41 males]. Fasting homocysteine were determined in serum separated within 1 h of blood collection using a fluorescence polarization immunoassay technique. Results The mean homocysteine level was （17.85±8.65） μmol/L,（22.15±10.45）μmol/L in group A and group B, and in the healthy control group was （12.74±3.32） μmol/L （P〈0.001）. Twenty-six （57.8%） patients of the group A and eleven （68.8%） patients of the group B had hyperhomocysteinemia compared to 15 （30%） in the healthy control group. Univariate logistic regression showed that a 4.78-fold greater risk of AD in subjects who had the HHcy, as compared with those having normal Hey level（OR=4.78; 95% CI= 1.21, 18.92, P〈0.05）. Conclusion This study shows significantly higher levels of plasma homocysteine in aortic dissection patients. Hyperhomocysteinemia is suggested to be an independent risk factor for aortic dissection. More clinical studies in this direction are warranted.