急性冠状动脉综合征患者冠状循环内中性粒细胞髓过氧化物酶的变化  

Changes of neutrophil myeloperoxidase in coronary circulation among patients with acute coronary syndrome

作　　者：黎莉[1] 张运[1] 陈玉国[1] 李贵双[1] 王颖[1] 马骁[1] 李继福[1] 钟明[1] 张薇[1] 

机构地区：[1]教育部和卫生部心血管重构和功能研究重点实验室山东大学齐鲁医院心内科,济南250012

出　　处：《中华心血管病杂志》2005年第12期1106-1108,共3页Chinese Journal of Cardiology

基　　金：卫生部临床学科重点项目;山东省医药卫生科研项目(编号2004-2006)

摘　　要：目的研究急性冠状动脉综合征患者体循环和冠状循环内中性粒细胞髓过氧化物酶(MPO)浓度梯度的改变及其临床意义。方法50例行冠状动脉造影患者分为急性心肌梗死(AMI)组10例、不稳定性心绞痛(UA)组20例、稳定性心绞痛(SA)组10例和对照组10例,同时抽取股静脉、主动脉根部及冠状静脉窦血测定中性粒细胞MPO浓度及高敏C反应蛋白(hs-CRP)水平。结果(1)冠心病各亚组均较对照组的低密度脂蛋白(LDL)水平升高(P均<0.05)。(2)UA组冠状静脉窦血MPO门内百分数显著低于主动脉根部(P<0.01),MPO门内百分数在冠状循环显著低于体循环(P<0.001);AMI组冠状静脉窦血MPO平均荧光强度显著低于主动脉根部(P<0.05),MPO平均荧光强度在冠状循环显著低于体循环(P<0.001);而对照组和SA组股静脉、主动脉根部和冠状静脉窦血中的MPO和hs-CRP含量差异均无统计学意义(P>0.05)。(3)UA组MPO门内百分数与hs-CRP呈正相关(r=0.78,P<0.01);与LDL呈正相关(r=0.52,P<0.05);AMI组MPO平均荧光强度与hs-CRP呈负相关(r=-0.80,P<0.05);与LDL无相关性(r=0.22,P>0.05)。结论MPO是反映冠状循环动脉粥样硬化斑块局部炎症的较好指标;通过MPO途径使LDL成为氧化型LDL,可能是斑块不稳定的机制之一。Objective To investigate the changes of neutrophil myeloperoxidase （MPO） blood concentration gradient between the systemic circulation and the coronary circulation among patients with acute coronary syndrome and its clinical value. Methods Fifty patients underwent coronary angiography, which including 10 patients in AMI group, 20 patients in UA group, 10 patients in SA group and 10 subjects served as control. The levels of MPO and hs-CRP were measured in the serum of blood collected from femoral vein, aortic artery root and coronary sinus. Results Compared with the control, concentrations of LDL in the AMI, UA and SA groups were significantly increased,while the latter three groups did not differ from each other. In the UA patients, the in-gate percentage of MPO decreased in the coronary sinus compared with that in the root of aortic artery （P 〈 0. 01 ） ; the in-gate percentage of MPO decreased through coronary circulation more than through systemic circulation （P 〈 0. 001 ） ; the average fluorescent intensity of MPO and the concentrations of hs-CRP showed no difference between samples from the coronary sinus and that from the root of aortic artery. In the AMI patients, the average fluorescent intensity of MPO in the coronary sinus was weakened compared with that in the root of aortic artery （ P 〈 0. 05 ） ; it decreased through coronary circulation more than through systemic circulation （ P 〈 0. 001 ） ; neither the in-gate percentage of MPO nor the concentrations of hs-CRP showed significant difference between samples from the coronary sinus and that from the root of aortic artery. In the control and SA groups, samples from the femoral vein, the root of aortic artery, and the coronary sinus did not show differences at the serum level of MPO and hs-CRP. In the UA group, the in-gate percentage of MPO correlated positively with the concentration of hs-CRP（ r = 0. 78,P〈0. 01）, and with the level of LDL as well （r =0. 52,P 〈0. 05） ; In the AMI group, the average fluorescent inte

关 键 词：冠状动脉疾病 冠状动脉循环 过氧化物酶 急性冠状动脉综合征 髓过氧化物酶 中性粒细胞 冠状循环 急性心肌梗死(AMI) 患者 动脉粥样硬化斑块 

分 类 号：R543[医药卫生—心血管疾病]