高同型半胱氨酸血症：视网膜中央静脉阻塞的一个新危险因素。
Hyperhomocysteinemia: a new risk factor for central retinal vein occlusion.
作者信息
Vine A K
机构信息
University of Michigan Medical School, Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, Ann Arbor, Michigan, USA.
出版信息
Trans Am Ophthalmol Soc. 2000;98:493-503.
PURPOSE
Previous studies have documented that an elevated plasma homocysteine level is a risk factor for vascular disease. The purpose of this study is to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.
METHODS
This case-controlled study involved reassessment of 74 patients with documented central retinal vein occlusion. Control subjects consisted of individuals referred to the same clinic for assessment of a nonretinal vascular disease. Hyperhomocysteinemia was defined as a total plasma homocysteine level above the 95th percentile in the control group.
RESULTS
The mean total plasma homocysteine level was 11.58 mumol/L for cases and 9.49 mumol/L for controls. Of the 74 patients with a central retinal vein occlusion, 21.6% had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81 to 23.50, P = .003). Hyperhomocysteinemia was present in 55% of cases with bilateral disease, 30% of ischemic cases, and 31% of cases with severe visual loss.
CONCLUSION
Hyperhomocysteinemia is a risk factor for central retinal vein occlusion.
目的
既往研究表明，血浆同型半胱氨酸水平升高是血管疾病的危险因素。本研究旨在确定高同型半胱氨酸血症是否为视网膜中央静脉阻塞的危险因素。
方法
本病例对照研究对74例有记录的视网膜中央静脉阻塞患者进行了重新评估。对照组由因非视网膜血管疾病到同一诊所进行评估的个体组成。高同型半胱氨酸血症定义为血浆总同型半胱氨酸水平高于对照组的第95百分位数。
结果
病例组血浆总同型半胱氨酸平均水平为11.58μmol/L，对照组为9.49μmol/L。在74例视网膜中央静脉阻塞患者中，21.6%的患者血浆总同型半胱氨酸水平高于对照组的第95百分位数（比值比，6.53；95%置信区间，1.81至23.50，P = 0.003）。双侧疾病患者中55%存在高同型半胱氨酸血症，缺血性病例中30%存在，严重视力丧失病例中31%存在。
结论
高同型半胱氨酸血症是视网膜中央静脉阻塞的危险因素。
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