中青年视网膜静脉阻塞与同型半胱氨酸、抗凝血酶III相关研究

Association of Retinal Veinocclusion with Homocysteine and Antithrombin III in Middle-Aged Adults

摘要: 目的：研究分析中青年视网膜静脉阻塞(Retinal Vein Occlusion, RVO)患者同型半胱氨酸(Homocysteine, Hcy)及抗凝血酶III (Antithrombin III, AT-III)水平，两者是否作为致病危险因素参与RVO发病。分析视网膜中央静脉阻塞(CRVO)和视网膜分支静脉阻塞(BRVO)危险因素的差异，为治疗和预防该病提供客观依据。方法：1) 所有研究对象选自2021年10月至2023年12月期间就诊于内蒙古自治区人民医院眼科的年龄 < 50岁中青年患者。2) 依据患者初次就诊时的检查结果选择了60例患有视网膜静脉阻塞的患者(共60只眼)作为病例组，根据阻塞部位分为两组：为视网膜中央静脉阻塞(CRVO)组和视网膜分支静脉阻塞(BRVO)组各30人。另30名为我院同期就诊的健康体检者作为对照组。3) 分析记录每个研究对象的一般情况，实验室检查指标患者所有临床资料输入计算机，应用SPSS29.0软件进行统计学处理。结果：1) 中青年CRVO、BRVO及对照组在年龄、性别、吸烟、饮酒、高血压、糖尿病、白细胞、中性粒细胞、血小板、单核细胞、淋巴细胞、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白(LDL)极低密度脂蛋白(VLDL)、甘油三酯(TG)水平差异无统计学意义(P > 0.05)。三组患者之间在Hcy、AT-III、胆固醇(CHOL)、叶酸、维生素B12、D-二聚体(D-D)、纤维蛋白降解产物(FDP)水平差异均有统计学意义(P < 0.05)。中青年RVO各亚组间的Hcy、AT-III活性差异具有统计学意义(P < 0.01)。2) 经Pearson相关性分析，发现中青年RVO患者的Hcy和AT-III之间存在负相关关系(r = −0.901, P < 0.001)。结论：1) Hcy水平升高和AT-III活性缺乏为中青年CRVO和BRVO的危险因素。2) 相对于BRVO患者，CRVO组中Hcy水平升高和AT-III缺乏的值更为显著。

Abstract: Objective: To investigate and analyze the levels of homocysteine (Hcy) and antithrombin III (AT-III) in young and middle-aged patients with retinal vein occlusion (RVO), and whether the two factors are pathogenic risk factors for RVO. To analyze the differences in risk factors for central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO), providing objective basis for the treatment and prevention of the disease. Method: 1) All research subjects were selected from young and middle-aged patients under 50 years old who visited the ophthalmology department of Inner Mongolia People’s Hospital from October 2021 to December 2023. 2) Sixty patients (60 eyes) with retinal vein occlusion were selected as a case group based on the examination results at the time of the patients’ first visit, and were divided into two groups according to the location of the occlusion: the central retinal vein occlusion (CRVO) group and the branch retinal vein occlusion (BRVO) group, each with 30 patients. The other 30 were healthy medical examiners who visited our hospital during the same period as the control group. 3) All the data were statistically processed using the SPSS29.0 software system. Results: 1) There were no statistically significant differences in age, gender, smoking, alcohol consumption, hypertension, diabetes mellitus, leukocytes, neutrophils, platelets, monocytes, lymphocytes, high-density lipoprotein cholesterol (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL), and triglyceride (TG) levels between the young and middle-aged CRVO, BRVO and the control group (P > 0.05). Differences in the levels of Hcy, AT-III, cholesterol (CHOL), folic acid, vitamin B12, D-dimer (D-D), and fibrin degradation products (FDP) were statistically significant among the three groups (P < 0.05). The differences in Hcy and AT-III activities between the subgroups of young and middle-aged RVO were statistically significant (P < 0.01). 2) After Pearson correlation analysis, a negative correlation was found between Hcy and AT-III in young and middle-aged RVO patients (r = −0.901, P < 0.001). Conclusion: 1) Elevated Hcy levels and lack of AT-III activity are risk factors for CRVO and BRVO in young and middle-aged people. 2) The values of elevated Hcy levels and AT-III deficiency were more significant in the CRVO group relative to BRVO patients.