骨科创伤患者血浆同型半胱氨酸水平临床分析
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摘要
目的探讨血浆同型半胱氨酸(Hcy)在骨科创伤患者中的临床指导意义。方法回顾性分析79例骨科创伤患者的资料,根据患者性别、年龄、创伤部位、是否吸烟、是否合并高血压、糖尿病、高甘油三酯血症、高胆红素血症、肝功能异常、肾功能异常分组,其中79例患者中合并下肢创伤53例,根据其是否合并深静脉血栓分组。结果纳入研究的患者Hcy为(17. 79±6. 79)μmol/L,58例男性患者Hcy为(18. 62±7. 55)μmol/L,21例女性患者Hcy为(15. 47±3. 10)μmol/L,性别比较差异有统计学意义(P <0. 05); 53例下肢创伤患者中,22例合并深静脉血栓患者Hcy为(19. 27±6. 41)μmol/L,31例不合并深静脉血栓患者Hcy为(15. 16±3. 37)μmol/L,2组间比较差异有统计学意义(P <0. 05)。结论骨科创伤患者的Hcy均值属于高同型半胱氨酸血症水平(HHcy)。男性血浆Hcy均值水平明显高于女性,合并深静脉血栓组患者血浆Hcy均值水平明显高于不合并深静脉组。
Objective To observe the clinical significance of plasma homocysteine(Hcy) in orthopedic trauma patients.Methods The data of 79 orthopaedic trauma patients were retrospectively analyzed. They were divided into different groups according to gender,age,traumatic site,whether or not smoking,combined hypertension,diabetes,hypertriglyceridemia,hyperbilirubinemia,abnormal liver function,abnormal renal function. 53 patients were associated with lower limb trauma,and they were divided according to whether they had deep venous thrombosis or not. The independent sample T test was used for comparison between the two groups. The one-way ANOVA analysis of variance was used for comparison between more than two groups. Results The mean of Hcy in all patients was 17. 79 ± 6. 79μmol/L,the mean of Hcy in 58 males was 18. 62 ± 7. 55μmol/L,and the mean of Hcy in 21 females was(15. 47 ±3. 10) μmol/L. There was a significant difference in gender(P < 0. 05). The mean of Hcy in 22 patients with deep venous thrombosis was 19. 27 ± 6. 41μmol/L. The mean of Hcy in 31 patients without deep venous thrombosis was(15. 16 ± 3. 37) μmol/L. There was a significant difference between the two groups(P < 0. 05). Conclusion The mean of Hcy in all orthopedic trauma patients is high homocysteine level(HHcy). The mean of plasma homocysteine level in males is significantly higher than that in females. The mean of plasma homocysteine level in patients with deep venous thrombosis was significantly higher than that in those patients without deep venous thrombosis.
Objective To observe the clinical significance of plasma homocysteine(Hcy) in orthopedic trauma patients.Methods The data of 79 orthopaedic trauma patients were retrospectively analyzed. They were divided into different groups according to gender,age,traumatic site,whether or not smoking,combined hypertension,diabetes,hypertriglyceridemia,hyperbilirubinemia,abnormal liver function,abnormal renal function. 53 patients were associated with lower limb trauma,and they were divided according to whether they had deep venous thrombosis or not. The independent sample T test was used for comparison between the two groups. The one-way ANOVA analysis of variance was used for comparison between more than two groups. Results The mean of Hcy in all patients was 17. 79 ± 6. 79μmol/L,the mean of Hcy in 58 males was 18. 62 ± 7. 55μmol/L,and the mean of Hcy in 21 females was(15. 47 ±3. 10) μmol/L. There was a significant difference in gender(P < 0. 05). The mean of Hcy in 22 patients with deep venous thrombosis was 19. 27 ± 6. 41μmol/L. The mean of Hcy in 31 patients without deep venous thrombosis was(15. 16 ± 3. 37) μmol/L. There was a significant difference between the two groups(P < 0. 05). Conclusion The mean of Hcy in all orthopedic trauma patients is high homocysteine level(HHcy). The mean of plasma homocysteine level in males is significantly higher than that in females. The mean of plasma homocysteine level in patients with deep venous thrombosis was significantly higher than that in those patients without deep venous thrombosis.
引文
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[14] Eldibany MM,Caprini JA. Hyperhomocysteinemia and thrombosis:an overview[J]. Archives of Pathology&Laboratory Medicine,2007,131(6):872-884.
[15] Leoncini G,Bruzzese D,Signorello MG. Activation of p38 MAPKinase/c PLA2 pathway in homocysteine-treated platelets[J]. Journal of Thrombosis and Haemostasis,2006,4(1):209-216.
[16]薛莉,陈树兰,贾绍斌,等.同型半胱氨酸与冠心病的相关性及其机制探讨[J].中华心血管病杂志,2002,30(9):520-524.
[17] Okumura K,Tsukamoto H. Folate in smokers[J]. Clinica Chimica acta,2011,412(7/8):521-526.
[18] Tungtrongchitr R,Pongpaew P,Soonthornruengyot M,et al. Relationship of tobacco smoking with serum vitamin B12,folic acid and haematological indices in healthy adults[J]. Public Health Nutrition,2003,6(7):675-681.
[2] Ganguly P,Alam SF. Role of homocysteine in the development of cardiovascular disease[J]. Nutrition Journal,2015,14:6.
[3]田锦林,王海峰,曲尔青,等.下肢深静脉血栓形成患者血浆同型半胱氨酸水平升高的相关因素探讨[J].血栓与止血学,2015,21(1):1-4.
[4]张科,黄雯婷,胡丽华,等.同型半胱氨酸和D-二聚体在骨折并发深静脉血栓患者中的临床意义[J].临床血液学杂志,2016,29(6):456-458.
[5] Fratoni V,Brandi ML. B vitamins homocysteine and bone health[J]. Nutrients,2015,7(4):2176-2192.
[6] Rahmani A,Masoud H,Masoud MD,et al. Correlation between serum homocysteine levels and outcome of patients with severen traumatic brain Injury[J]. World Neurosurgery,2016,87:507-515.
[7] Yang J,Hu X,Zhang Q,et al. Homocysteine level and risk of fracture:a meta-analysis and systematic review[J]. Bone,2012,51(3):376-382.
[8]王薇,赵冬,刘军,等.北京城乡人群1168例血浆同型半胱氨酸分布及相关因素研究[J].中华流行病学杂志,2002,23(1):32-35.
[9] Sakamoto W,Isomura H,Fujie K,et al. Homocysteine attenuates the expression of osteocalcin but enhances osteopontin in MC3T3-E1preosteoblastic cells[J]. Biochimica Biophysica Acta,2005,1740(1):12-16.
[10] Van Der Mooren MJ,Wouters MG,Blom HJ,et al. Hormone replacement therapy may reduce high serum homocysteine in postmenopausal women[J]. European Journal of Clinical Investigation,1994,24(11):733-736.
[11] Wilcken DE,Gupta VJ. Cysteine-homocysteine mixed disulphide:differing plasma concentrations in normal men and women[J]. Clinical Science,1979,57(2):211-215.
[12] Mudd SH,Poole JR. Labile methyl balances for normal humans on various dietary regimens[J]. Metabolism,1975,24(6):721-735.
[13] Andersson A,Hultberg B,Brattstram L,et al. Decreased serumhomocysteine in pregnancy[J]. European Journal of Clinical Chemistry and Clinical Biochemistry,1992,30:377-379.
[14] Eldibany MM,Caprini JA. Hyperhomocysteinemia and thrombosis:an overview[J]. Archives of Pathology&Laboratory Medicine,2007,131(6):872-884.
[15] Leoncini G,Bruzzese D,Signorello MG. Activation of p38 MAPKinase/c PLA2 pathway in homocysteine-treated platelets[J]. Journal of Thrombosis and Haemostasis,2006,4(1):209-216.
[16]薛莉,陈树兰,贾绍斌,等.同型半胱氨酸与冠心病的相关性及其机制探讨[J].中华心血管病杂志,2002,30(9):520-524.
[17] Okumura K,Tsukamoto H. Folate in smokers[J]. Clinica Chimica acta,2011,412(7/8):521-526.
[18] Tungtrongchitr R,Pongpaew P,Soonthornruengyot M,et al. Relationship of tobacco smoking with serum vitamin B12,folic acid and haematological indices in healthy adults[J]. Public Health Nutrition,2003,6(7):675-681.