测定血浆同型半胱氨酸的临床意义：动脉和静脉血栓形成患者的病例对照研究

Clinical significance of determining plasma homocysteine: case-control study on arterial and venous thrombotic patients.

作者信息

Vuckovic Biljana A, Cabarkapa Velibor S, Ilic Tatjana A, Salatic Iva R, Lozanov-Crvenkovic Zagorka S, Mitic Gorana P

机构信息

Biljana A. Vuckovic, Department of Hemostasis, Thrombosis and Hematology Diagnostics, Centre for Laboratory Medicine, Clinical Centre of Vojvodina, Hajduk Veljkova 1-7, 21000 Novi Sad, Serbia,

出版信息

Croat Med J. 2013 Oct 28;54(5):480-8. doi: 10.3325/cmj.2013.54.480.

DOI:10.3325/cmj.2013.54.480

PMID:24170727

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3816557/

Abstract

AIM

To determine the differences in plasma homocysteine levels between three MTHFR 677 genotype subgroups in patients with thrombosis and in controls, as well as between patients with thrombosis and controls with the same MTHFR 677 genotype.

METHODS

This case-control study was conducted in Clinical Center of Vojvodina, Novi Sad, from June to December 2011. We included 65 patients with either arterial or venous thrombosis (mean age, 40.97 ± 11.38 years) and 65 controls with no history or clinical evidence of any thrombotic event (mean age, 41.23 ± 11.12 years). Patients and controls were age- and sex-matched.

RESULTS

In comparison with controls, thrombotic patients had significantly higher homocysteine levels (12.81 ± 4.94 µmol/L vs 9.82 ± 3.68 µmol/L; P<0.001) and significantly higher incidence of hyperhomocysteinemia (55% vs 22%; P<0.001; odds ratio [OR]=4.521). There were no significant differences in homocysteine levels between homozygous carriers, heterozygous carriers, and non-carriers of the MTHFR 677 mutation in either thrombotic patients (12.97 ± 5.40 µmol/L vs 12.55 ± 5.71 µmol/L vs 13.27 ± 1.71 µmol/L; P=0.100) or controls (10.07±2.50 µmol/L vs 10.25 ± 4.84 µmol/L vs 9.20 ± 2.44 µmol/L; P=0.651). However, in comparison with controls, homozygous carriers in thrombotic patient group did not have significantly higher levels of homocysteine (12.97 ± 5.40 µmol/L vs 10.07 ± 2.50 µmol/L; P=0.072), but heterozygous carriers (12.55 ± 5.71 µmol/L vs 10.25 ± 4.84 µmol/L; P=0.020) and non-carriers (13.27 ± 1.71 µmol/L vs 9.20 ± 2.44 µmol/L; P<0.001) did. There was no significant difference in homocysteine levels between patients with arterial and venous thrombosis (12.76 ± 3.60 µmol/L vs 12.86 ± 5.51 µmol/L; P=0.990) and between patients with one thrombotic event and those with recurrent thrombotic events (12.14 ± 3.20 µmol/L vs 15.25 ± 8.51 µmol/L; P=0.254).

CONCLUSION

Plasma homocysteine levels have a greater clinical significance in the prevention of thrombosis and managing its complications than MTHFR 677 genotyping.

摘要

目的

确定血栓形成患者和对照组中三种亚甲基四氢叶酸还原酶（MTHFR）677基因型亚组之间血浆同型半胱氨酸水平的差异，以及相同MTHFR 677基因型的血栓形成患者与对照组之间的差异。

方法

本病例对照研究于2011年6月至12月在诺维萨德伏伊伏丁那临床中心进行。我们纳入了65例动脉或静脉血栓形成患者（平均年龄40.97±11.38岁）和65例无任何血栓形成事件病史或临床证据的对照组（平均年龄41.23±11.12岁）。患者和对照组在年龄和性别上匹配。

结果

与对照组相比，血栓形成患者的同型半胱氨酸水平显著更高（12.81±4.94μmol/L对9.82±3.68μmol/L；P<0.001），高同型半胱氨酸血症的发生率显著更高（55%对22%；P<0.001；比值比[OR]=4.521）。在血栓形成患者（12.97±5.40μmol/L对12.55±5.71μmol/L对13.27±1.71μmol/L；P=0.100）或对照组（10.07±2.50μmol/L对10.25±4.84μmol/L对9.20±2.44μmol/L；P=0.651）中，MTHFR 677突变的纯合子携带者、杂合子携带者和非携带者之间的同型半胱氨酸水平无显著差异。然而，与对照组相比，血栓形成患者组中的纯合子携带者同型半胱氨酸水平没有显著更高（12.97±5.40μmol/L对10.07±2.50μmol/L；P=0.072），但杂合子携带者（12.55±5.71μmol/L对10.25±4.84μmol/L；P=0.020）和非携带者（13.27±1.71μmol/L对9.20±2.44μmol/L；P<0.001）的同型半胱氨酸水平显著更高。动脉血栓形成患者和静脉血栓形成患者之间（12.76±3.60μmol/L对12.86±5.51μmol/L；P=0.990）以及发生一次血栓形成事件的患者和复发性血栓形成事件的患者之间（12.14±3.20μmol/L对15.25±8.51μmol/L；P=0.254）的同型半胱氨酸水平无显著差异。