Lindholt J S, Ashton H A, Heickendorff L, Scott R A
Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
Eur J Vasc Endovasc Surg. 2001 Dec;22(6):546-50. doi: 10.1053/ejvs.2001.1516.
Serum elastin peptides (SEP) have been reported to be associated with the expansion of small abdominal aortic aneurysms (AAA). Consequently, SEP-measurements may predict future rupture, and allow further selection for surgery in cases referred for surgery due to size.
SEP was measured in 90 men and 10 women with AAA, who were considered for surgery as part of the Chichester aneurysm screening programme. Sixty-one patients were electively operated and four because of symptoms. The rest were followed up further. Twelve of these experienced ruptured AAA later.
No correlation between last measured AAA-diameter, annual expansion rate and SEP was noticed. However, SEP levels were significantly higher in cases rupturing later, persisting after adjustment for age, sex, and last measured AAA-size. ROC curve analysis concerning SEP as a predictor of rupture later showed an optimal sensitivity and specificity of 67% and 60%, respectively, similar with last measured AAA-size. By combining AAA-size and SEP, the optimal sensitivity and specificity reached 83% and 66%, respectively.
One sampling of SEP combined with AAA-size in patients referred for AAA surgery may be a clinical useful indicator of high rupture risk.
血清弹性蛋白肽（SEP）已被报道与小腹主动脉瘤（AAA）的扩张有关。因此，SEP检测可能预测未来破裂情况，并有助于在因尺寸原因而转诊接受手术的病例中进一步筛选手术对象。
对90名男性和10名患有AAA的女性进行SEP检测，这些患者作为奇切斯特动脉瘤筛查项目的一部分被考虑进行手术。61例患者接受了择期手术，4例因出现症状而手术。其余患者进行进一步随访。其中12例后来发生了AAA破裂。
未发现最后测量的AAA直径、年扩张率与SEP之间存在相关性。然而，在后来发生破裂的病例中，SEP水平显著更高，在对年龄、性别和最后测量的AAA尺寸进行调整后仍持续存在。关于SEP作为后期破裂预测指标的ROC曲线分析显示，最佳敏感性和特异性分别为67%和60%，与最后测量的AAA尺寸相似。通过结合AAA尺寸和SEP，最佳敏感性和特异性分别达到83%和66%。
在转诊接受AAA手术的患者中，一次SEP检测结合AAA尺寸可能是高破裂风险的临床有用指标。
