The association of elevated plasma homocyst(e)ine with progression of symptomatic peripheral arterial disease.
The association of elevated plasma homocyst(e)ine with progression of symptomatic peripheral arterial disease.
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DOI：
10.1016/0741-5214(91)90020-u
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发表时间：
1991
影响因子：
4.3
通讯作者：
L. Taylor;R. Defrang;E. Harris;J. Porter
中科院分区：
文献类型：
--
作者：
L. Taylor;R. Defrang;E. Harris;J. Porter
血浆同型半胱氨酸采用高效液相色谱法测定了214例有症状的高同型半胱氨酸（游离和结合同型半胱氨酸、同型半胱氨酸和混合二硫同型半胱氨酸-半胱氨酸之和，以同型半胱氨酸表示）水平。（跛行、静息痛、坏疽、截肢）下肢动脉闭塞性疾病和/或症状性（中风，脑短暂性缺血发作）脑血管疾病和103名对照人员。血浆同型半胱氨酸水平（14.37 ± 6.89 nmol/ml）明显高于对照组（10.10 ± 2.16，P < 0.05）。39%的患者（83/214）血浆同型半胱氨酸值大于对照组平均值+2标准差。将血浆同型半胱氨酸值与年龄、男性、糖尿病、高血压、吸烟、肾衰竭和血浆胆固醇进行对比。通过单变量和多变量分析，将血浆同型半胱氨酸正常的患者与血浆同型半胱氨酸升高的患者进行比较，未发现任何这些危险因素的发生率和/或水平存在差异。血浆同型半胱氨酸水平升高的患者比血浆同型半胱氨酸水平正常的患者更可能出现下肢疾病和冠状动脉疾病的临床进展，但不可能出现脑血管疾病的临床进展，并且进展速度更快（p= 0.002）。血管实验室评估的下肢疾病进展在血浆同型半胱氨酸升高的患者中也更常见（p= 0.01）。我们的结论是血浆同型半胱氨酸升高是下肢疾病或脑血管疾病或两者的独立危险因素。有下肢疾病和血浆同型半胱氨酸升高的症状性患者似乎也有更快的疾病进展。（J VASCSurg1991;13：128-36.）
Plasma homocyst(e)ine (the sum of free and bound homocysteine, homocystine, and the mixed disulfide homocysteine-cysteine, expressed as homocysteine) levels were determined by high performance liquid chromatography in 214 patients with symptomatic (claudication, rest pain, gangrene, amputation) lower extremity arterial occlusive disease and/or symptomatic (stroke, cerebral transient ischemic attacks) cerebral vascular disease and in 103 control persons. Mean plasma homocyst(e)ine was significantly higher in patients than in controls (14.37 ± 6.89 nmol/ml vs 10.10 ± 2.16,p< 0.05). Thirty-nine percent of patients (83 of 214) had plasma homocyst(e)ine values greater than control mean + 2 standard deviations. Plasma homocyst(e)ine values were contrasted to age, male sex, diabetes, hypertension, smoking, renal failure, and plasma cholesterol. No difference was found in the incidence and/or level of any of these risk factors when patients with normal plasma homocyst(e)ine were compared to those with elevated plasma homocyst(e)ine, both by univariate and multivariate analysis. Patients with elevated plasma homocyst(e)ine were more likely to demonstrate clinical progression of lower extremity disease and of coronary artery disease, but not of cerebral vascular disease than were patients with normal plasma homocyst(e)ine, and the rate of progression was more rapid (p= 0.002). Progression of lower extremity disease as assessed in the vascular laboratory was also more common in patients with elevated plasma homocyst(e)ine (p= 0.01). We conclude that elevated plasma homocyst(e)ine is an independent risk factor for symptomatic lower extremity disease or cerebral vascular disease or both. Symptomatic patients with lower extremity disease and with elevated plasma homocyst(e)ine also appear to have more rapid progression of disease. (J VASCSURG1991;13:128-36.)