The role of alpha-1-antitrypsin in the etiopathogenesis of chronic venous disease: A prospective clinical trial.

IF 1.6 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Phlebology Pub Date : 2023-02-01 DOI:10.1177/02683555221141818
Hüsnü Kamil Limandal, Mehmet Ali Kayğın, Alev Lazoğlu Özkaya, Taha Özkara, Mevriye Serpil Diler, Hatice Işıl Çüçen, Ziya Yıldız, Servet Ergün, Özgür Dağ
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引用次数: 1

Abstract

Objective: The study aimed to examine whether alpha-1-antitrypsin (AAT), an inhibitor of leukocyte esterase(LE), which damages the venous vessel wall, has a protective effect against chronic venous disease(CVD), and to examine the relationship between AAT levels and disease severity.

Methods: Patients admitted with varicose vein disease and having reflux flow lasting longer than 0.5 s as determined by Doppler ultrasound were included. The informed consents were taken, and blood samples were obtained for complete blood count, C-reactive protein (CRP) level, and AAT level following anamnesis and physical examination. Clinical Etiologic Anatomic Pathologic (CEAP) classification was used to assess disease severity, and patients were divided into CEAP 1-5 groups accordingly.

Results: A total of 87 patients were included in the study. There was no statistically significant difference between the groups in body weight, red blood cell counts, platelet counts, or neutrophil counts (p = 0.117, p = 0.932, p = 0.177, and p = 0.177, respectively).CRP and AAT levels were higher in patients with a CEAP clinical score of 5 compared to the other groups (p = 0.018, and p = 0.020, respectively). AAT levels were similar in the CEAP 1-3 group and decreased in the CEAP-4 group but increased again in the CEAP-5 group. The AAT level was 1.62 ± 0.3 g/L in the CEAP-1 group, 1.61 ± 0.21 g/L in the CEAP-2 group, 1.61 ± 0.27 g/L in the CEAP-3 group, 1.48 ± 0.28 g/L in the CEAP-4 group, and 1.94 ± 0.39 g/L in the CEAP-5 group. CRP levels and platelet counts were observed to affect AAT levels (p = 0.10, p = 0.017, respectively).

Conclusion: We believe that our hypothesis that low AAT levels play a role in the etiopathogenesis of CVD has been partially validated, at least in the CEAP-4 group. However, we believe that increased AAT levels in the CEAP-5 group may be a reactive increase in increased LE levels due to higher CRP levels of this group.

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α -1-抗胰蛋白酶在慢性静脉疾病发病机制中的作用:一项前瞻性临床试验
目的:研究白细胞酯酶(LE)抑制剂α -1-抗胰蛋白酶(AAT)是否对慢性静脉疾病(CVD)有保护作用,并探讨AAT水平与疾病严重程度的关系。方法:纳入经多普勒超声检查为静脉曲张且返流持续时间大于0.5 s的患者。接受知情同意书,并在体检后进行全血细胞计数、c反应蛋白(CRP)水平和AAT水平的采集。采用临床病因解剖病理(Clinical Etiologic Anatomic Pathologic, CEAP)分级评估疾病严重程度,并将患者分为CEAP 1 ~ 5组。结果:共纳入87例患者。两组患者体重、红细胞计数、血小板计数、中性粒细胞计数差异无统计学意义(p = 0.117、p = 0.932、p = 0.177、p = 0.177)。CEAP临床评分为5分的患者CRP和AAT水平高于其他组(p = 0.018, p = 0.020)。AAT水平在CEAP 1-3组中相似,在CEAP-4组中下降,而在CEAP-5组中再次升高。AAT水平CEAP-1组为1.62±0.3 g/L, CEAP-2组为1.61±0.21 g/L, CEAP-3组为1.61±0.27 g/L, CEAP-4组为1.48±0.28 g/L, CEAP-5组为1.94±0.39 g/L。观察到CRP水平和血小板计数影响AAT水平(p = 0.10, p = 0.017)。结论:我们认为,低AAT水平在CVD发病机制中起作用的假设已部分得到证实,至少在CEAP-4组中是这样。然而,我们认为CEAP-5组中AAT水平升高可能是由于该组CRP水平升高导致LE水平升高的反应性升高。
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来源期刊
Phlebology
Phlebology 医学-外周血管病
CiteScore
3.30
自引率
11.80%
发文量
84
审稿时长
6-12 weeks
期刊介绍: The leading scientific journal devoted entirely to venous disease, Phlebology is the official journal of several international societies devoted to the subject. It publishes the results of high quality studies and reviews on any factor that may influence the outcome of patients with venous disease. This journal provides authoritative information about all aspects of diseases of the veins including up to the minute reviews, original articles, and short reports on the latest treatment procedures and patient outcomes to help medical practitioners, allied health professionals and scientists stay up-to-date on developments. Print ISSN: 0268-3555
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