Hillenbrand Renata, Hillenbrand Andreas, Liewald Florian, Zimmermann Julian
Department of Vascular and Thoracic Surgery, University of Ulm, Ulm, German.
BMC Cardiovasc Disord. 2008 Jan 17;8:1. doi: 10.1186/1471-2261-8-1.
Hyperhomocysteinemia has been identified as a potential risk for atherosclerotic disease in epidemiologic studies. This study investigates the impact of elevated serum homocysteine on restenosis after carotid endarterectomy (CEA).
In a retrospective study, we compared fasting plasma homocysteine levels of 51 patients who developed restenosis during an eight year period after CEA with 45 patients who did not develop restenosis. Restenosis was defined as at least 50% stenosis and was assessed by applying a routine duplex scan follow up investigation. Patients with restenosis were divided into a group with early restenosis (between 3 and 18 months postoperative, a total of 39 patients) and late restenosis (19 and more months; a total of 12 patients).
The groups were controlled for age, sex, and risk factors such as diabetes, nicotine abuse, weight, hypertension, and hyperlipidemia. Patients with restenosis had a significant lower mean homocysteine level (9.11 micromol/L; range: 3.23 micromol/L to 26.49 micromol/L) compared to patients without restenosis (11.01 miccromol/L; range: 5.09 micromol/L to 23.29 micromol/L; p = 0.03). Mean homocysteine level in patients with early restenosis was 8.88 micromol/L (range: 3.23-26.49 micromol/L) and 9.86 micromol/L (range 4.44-19.06 micromol/L) in late restenosis (p = 0.50).
The finding suggests that high plasma homocysteine concentrations do not play a significant role in the development of restenosis following CEA.
在流行病学研究中，高同型半胱氨酸血症已被确定为动脉粥样硬化疾病的一个潜在风险因素。本研究调查血清同型半胱氨酸升高对颈动脉内膜切除术（CEA）后再狭窄的影响。
在一项回顾性研究中，我们比较了51例CEA术后8年内发生再狭窄的患者与45例未发生再狭窄的患者的空腹血浆同型半胱氨酸水平。再狭窄定义为至少50%的狭窄，并通过常规双功超声扫描随访检查进行评估。发生再狭窄的患者被分为早期再狭窄组（术后3至18个月，共39例患者）和晚期再狭窄组（19个月及以上；共12例患者）。
对两组患者的年龄、性别以及糖尿病、吸烟、体重、高血压和高脂血症等风险因素进行了对照。与未发生再狭窄的患者相比，发生再狭窄的患者平均同型半胱氨酸水平显著更低（9.11微摩尔/升；范围：3.23微摩尔/升至26.49微摩尔/升），未发生再狭窄的患者平均同型半胱氨酸水平为11.01微摩尔/升（范围：5.09微摩尔/升至23.29微摩尔/升；p = 0.03）。早期再狭窄患者的平均同型半胱氨酸水平为8.88微摩尔/升（范围：3.23 - 26.49微摩尔/升），晚期再狭窄患者为9.86微摩尔/升（范围4.44 - 19.06微摩尔/升）（p = 0.50）。
该研究结果表明，高血浆同型半胱氨酸浓度在CEA术后再狭窄的发生中不起重要作用。
