氧化应激和炎症反应在冠心病中的作用及其相互关系  

Effects of oxidative stress and inflammatory reaction in coronary heart disease and the interactions

作　　者：温先勇[1] 杭永伦[1] 邓辉胜[2] 刘永贵[3] 

机构地区：[1]泸州医学院附属医院检验科,四川省泸州市646000 [2]泸州医学院附属医院心内科,四川省泸州市646000 [3]泸州医学院附属医院放射科,四川省泸州市646000

出　　处：《中国临床康复》2005年第11期38-39,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:冠心病的病变存在着多种危险因素,通过测定患者氧化应激产物和炎症标志物的水平,旨在对冠心病的发病机制作一探讨。方法:泸州医学院附属医院心内科2002-05/2004-08收治的冠心病患者共87例,所有患者符合ISFC/WHO(1979)公布的冠心病诊断标准并经冠状动脉造影证实。其中符合以上标准患者71例,男46例,女25例,平均年龄(56.3±8.9)岁,测定其血浆C反应蛋白(C-reactivepro-tein,CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)和氧化型低密度脂蛋白(oxidizedlowdensitylipoprotein,OX-LDL)、丙二醛malondialdehyde,MDA的浓度;观察它们()与冠状动脉病变数量之间的关系;分析OX-LDL、MDA与CRP、IL-6、TNF-α相关性。结果:CRP、IL-6、TNF-α、OX-LDL及MDA在冠心病患者血浆中分别为(10.32±1.73)mg/L,(24.18±3.87)ng/L,(21.66±2.59)ng/L,(763.7±150.5)μg/L,(9.15±1.48)μmol/L,均显著高于对照组(t=11.908～31.521,P<0.01),并依照稳定性心绞痛组、不稳定性心绞痛组、急性心肌梗死组的次序明显升高(t=2.023～27.859,P<0.05～0.01);在按病变冠脉分组的患者中,依单支病变组、双支病变组、三支病变组次序递增(t=2.498～18.143,P<0.05～0.01);相关分析表明:OX-LDL与CRP。AIM: Coronary heart disease (CHD) is associated with many risk factors. This study aimed to investigate the pathogenesis of CHD by determining the levels of product of oxidative stress and inflammatory markers of CHD patients.METHODS: Eight seven CHD patients in the Department of Cardiology, Affiliated Hospital of Luzhou Medical College from May 2002 to August 2004 were selected.All the patients met the diagnostic standard of CHD published by ISFC/WHO in 1979 and confirmed by coronary angiography.Among them, 71 patients (46 males and 25 females), with an average age of (56.3± 8.9) years old, were involved in this study, their plasma concentrations of C reactive protein (CRP), interleukin 6 (IL 6), tumor necrosis factor alpha (TNF α ), oxidized low density lipoprotein (OX LDL) and malondialdehyde (MDA) were determined, their relationships with the numbers of damaged coronary vessels were observed, and the correlations of OX LDL and MDA with CRP, IL 6 and TNF α were analyzed.RESULTS: The plasma concentrations of CRP, IL 6, TNF α , OX LDL and MDA of the CHD patients[(10.32± 1.73) mg/L, (24.18± 3.87) ng/L, (21.66± 2.59) ng/L, (763.7± 150.5) μ g/L, (9.15± 1.48)μ mol/L] were markedly higher than those in the control group (t=11.908 to 31.521, P< 0.01), and the concentrations were obviously increased in the stable angina group, unstable angina group and acute myocardial infarction group (t=2.023 to 27.859, P< 0.05 to 0.01), and the concentrations were gradually increased with the increasing the numbers of diseased coronary vessels (t=2.498 to 18.143, P< 0.05 to 0.01). The correlation analysis showed that the OX LDL was significantly and positively correlated with CRP, IL 6 and TNF α (r=0.78, 0.62, 0.55, P< 0.05), MDA also had positive correlations with CRP, IL 6 and TNF α (r= 0.73, 0.60, 0.54, P< 0.05). CONCLUSION: Oxidative stress and inflammatory reaction are closely associated with CHD, and the interactions between them lead to the occurrence and development of CHD

关 键 词：冠心病 冠状动脉造影 炎症反应 氧化应激 

分 类 号：R541.4[医药卫生—心血管疾病]