Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Eye (Lond). 2011 Dec;25(12):1650-4. doi: 10.1038/eye.2011.232. Epub 2011 Sep 16.
To assess diagnostic efficacy of plasma total homocysteine (tHcy) and C-reactive protein (CRP) levels for ocular ischemic syndrome (OIS).
In all, 87 patients with retinal vein occlusion (RVO), 955 patients with a stenosis of internal carotid artery (ICA) <90% and 159 patients with a stenosis of ICA >90% were included between 2003 and 2009. A total of 43 patients with a stenosis ICA >90% were diagnosed as OIS. Fasting tHcy, CRP, lipid profiles, creatinine were measured, and diagnostic values of hyperhomocysteinemia or elevated CRP for OIS were evaluated.
The mean plasma levels of tHcy (18.8 μmol/l) and CRP (1.1 mmol/l) were the highest in patients with OIS among the groups. The prevalences of hyperhomocysteinemia (72%) and elevated CRP (77%) were the highest in OIS among the groups. In patients with stenosis of ICA, the diagnostic sensitivity/specificity for OIS was 70/79% in hyperhomocysteinemia and 73/73% in elevated CRP. The diagnostic sensitivity and specificity for OIS were 53 and 86% in both hyperhomocysteinemia and elevated CRP. The lipid profiles and creatinine levels were similar among the groups.
Our results suggest that hyperhomocysteinemia and elevated CRP may be associated with the development of OIS. The measurements of tHcy and CRP in blood may help to assist the diagnosis of OIS in a stenosis of ICA.
评估血浆总同型半胱氨酸（tHcy）和 C 反应蛋白（CRP）水平对眼部缺血综合征（OIS）的诊断效能。
纳入了 2003 年至 2009 年间的 87 例视网膜静脉阻塞（RVO）患者、955 例颈内动脉狭窄（ICA）<90%患者和 159 例 ICA 狭窄>90%患者。43 例 ICA 狭窄>90%的患者被诊断为 OIS。测量空腹 tHcy、CRP、血脂谱、肌酐，并评估高同型半胱氨酸血症或 CRP 升高对 OIS 的诊断价值。
在各组中，OIS 患者的血浆 tHcy（18.8 μmol/l）和 CRP（1.1 mmol/l）水平最高。高同型半胱氨酸血症（72%）和 CRP 升高（77%）在 OIS 患者中的患病率最高。在 ICA 狭窄患者中，高同型半胱氨酸血症对 OIS 的诊断灵敏度/特异性为 70/79%，CRP 升高为 73/73%。高同型半胱氨酸血症和 CRP 升高对 OIS 的诊断灵敏度和特异性分别为 53%和 86%。各组的血脂谱和肌酐水平相似。
我们的结果表明，高同型半胱氨酸血症和 CRP 升高可能与 OIS 的发生有关。血液中 tHcy 和 CRP 的测量可能有助于辅助 ICA 狭窄患者的 OIS 诊断。
