腹主动脉瘤患者腔内血栓厚度及外周血中同型半胱氨酸与C反应蛋浓度的临床意义及相互关系  

Clinical significance and interrelationship among intraluminal thrombus thickness and peripheral blood concentrations of homocysteine and C reactive protein in patients with abdominal aortic aneurysm

作　　者：邹睿[1] 胡新华[1] 吴孟然[1] 张鸣[1] 王修琪 李晓东[1] 蒋珊珊[1] 李楠[1] 张健[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属第一医院血管外科,辽宁沈阳110001

出　　处：《中国普通外科杂志》2017年第6期693-698,共6页China Journal of General Surgery

基　　金：辽宁省自然科学基金项目(2014021075)

摘　　要：目的:探讨腹主动脉瘤(AAA)患者瘤腔内血栓(ILT)厚度及外周血中同型半胱氨酸(Hcy)与C反应蛋白(CRP)浓度的临床意义及相互关系。方法:选取2014年1月—2015年12月年间收治的AAA患者60例,以ELISA法测定外周血中Hcy浓度和CRP浓度,影像学方法测定ILT厚度。分析ILT厚度与临床因素的关系,以及ILT厚度、Hcy、CRP之间的相互关系。结果:厚ILT(厚度≥7.8mm)患者的高血压史比例、Hcy和CRP浓度明显高于薄ILT(厚度<7.8mm)患者(均P<0.05);相关分析显示,Hcy浓度与ILT厚度(r=0.942)、ILT厚度/AAA最大直径比值(r=0.844)、AAA最大直径(r=0.505)均呈明显正相关(均P<0.05),而CRP浓度与其他因素间均无相关(均P>0.05)。结论:ILT厚度、外周血Hcy与CRP浓度均可能是AAA进展的危险因素,且ILT厚度与Hcy浓度之间可能存在相互促进的关系。Objective： To investigate the clinical significance and interrelationship among intraluminal thrombus （ILT） thickness and peripheral blood concentrations of homocysteine （Hcy） and C reactive protein （CRP） in patients with abdominal aortic aneurysm （AAA）. Methods： Sixty AAA patients admitted from January 2014 to December 2015 were selected, and their peripheral blood Hcy and CRP concentrations were measured by ELISA and ILT thicknesses were determined by imaging analysis. The relations of ILT thickness with clinical factors and the relationship among ILT thickness, Hcy and CRP were analyzed. Results： The proportion of cases with hypertension history5 and Hey and CRP concentrations in patients with thick ILT thickness （thickness≥7.8 mm） were significantly higher than those in patients with thin ILT thickness （thickness〈7.8 mm） （all P〈0.05）. Correlation analysis showed that Hcy level had a significant positive correlation with ILT thickness （r=0.942）, the ratio of ILT thickness to AAA maximum diameter （r=0.844）, and AAA maximum diameter （r=0.505） （all P〈0.05）, while CRP level had no significant correlation with other factors （all P〉0.05）. Conclusion： ILT thickness and peripheral blood Hcy and CRP concentrations are all potential risk factors for AAA progression. Further, there may be a mutual promotion between ILT thickness and Hcy concentration.

关 键 词：主动脉瘤 腹 血栓形成 高半胱氨酸 C反应蛋白质 

分 类 号：R654.3[医药卫生—外科学]