Department of Dermatology, Venereology and Allergology, University of Göttingen, Göttingen, Germany.
Wound Repair Regen. 2011 Mar-Apr;19(2):168-72. doi: 10.1111/j.1524-475X.2010.00657.x.
Chronic venous leg ulcers are common and cause considerable burden of disease for affected patients with significant costs for health care systems worldwide. The complex pathophysiology of chronic venous leg ulcers is still not entirely understood. In addition, reliable pathogenic and/or prognostic parameters are not known. Published data suggest that patients with chronic venous leg ulcers reveal congenital or acquired thrombophilia. We examined the serum Lipoprotein (a) [Lp(a)] level, a proatherogenic and prothrombotic risk factor, in patients with chronic venous leg ulcers (n=210, stratified into patients with postthrombotic syndrome or without) and in a healthy control group (n=341). Forty-two percent of all patients, compared with 20% of healthy controls, revealed significantly increased Lp(a) serum concentrations above 0.3 g/L. Furthermore, 49% without postthrombotic syndrome but only 35% with postthrombotic syndrome showed increased Lp(a) levels. The increase of Lp(a) level was significantly different between all three groups (p<0.001). There was no correlation of Lp(a) levels and CRP values in all groups. Based on these data, it is conceivable that Lp(a) plasma level is a novel pathogenic parameter for chronic venous leg ulcers. Elevated concentrations may contribute to the pathogenesis through induction of thrombogenic microcirculatory dysregulations, impaired extravascular fibrinolysis, or other mechanisms like proinflammatory effects.
慢性静脉性腿部溃疡很常见，给患病患者带来了相当大的疾病负担，给全球的医疗系统带来了巨大的成本。慢性静脉性腿部溃疡的复杂病理生理学仍不完全清楚。此外，也不知道可靠的发病机制和/或预后参数。已发表的数据表明，慢性静脉性腿部溃疡患者存在先天性或获得性血栓形成倾向。我们检测了慢性静脉性腿部溃疡患者（n=210，分为血栓后综合征患者和非血栓后综合征患者）和健康对照组（n=341）的血清脂蛋白（a）[Lp(a)]水平，这是一种促动脉粥样硬化和促血栓形成的危险因素。与健康对照组（20%）相比，所有患者中有 42%的患者血清 Lp(a)浓度显著升高，超过 0.3 g/L。此外，49%的非血栓后综合征患者但只有 35%的血栓后综合征患者显示 Lp(a)水平升高。三组之间的 Lp(a)水平升高差异具有统计学意义（p<0.001）。在所有组中，Lp(a)水平与 CRP 值均无相关性。基于这些数据，可以想象 Lp(a)血浆水平是慢性静脉性腿部溃疡的一种新的发病机制参数。升高的浓度可能通过诱导血栓形成的微循环失调、血管外纤维蛋白溶解受损或其他机制如促炎作用而导致发病机制。
