急性冠脉综合征患者血浆脂质过氧化物升高及意义  

Effect of lipid peroxidate in the patients with acute coronary syndrome

作　　者：冯毅[1] 王积慧[1] 沈成兴[1] 马根山[1] 

机构地区：[1]东南大学附属中大医院心内科,江苏南京210009

出　　处：《东南大学学报（医学版）》2007年第2期98-101,共4页Journal of Southeast University(Medical Science Edition)

基　　金：江苏省卫生厅开放课题资助项目(WK0510)

摘　　要：目的:通过检测急性冠脉综合征(ACS)患者体内脂质过氧化物丙二醛(MDA)、晚期蛋白氧化产物(AOPP)的水平来探讨氧化应激损伤与ACS发生发展的关系。方法:入选73例急性心肌梗死(AMI)[包括46例择期行经皮冠脉成形术(PCI)和27例行急诊PCI患者]、49例不稳定性心绞痛(UA)及21例非冠心病患者,均经冠脉造影证实。于入院即刻、24 h和48 h采集外周静脉血标本。硫代巴比妥分光光度法测定MDA浓度;紫外荧光光度法测定AOPP浓度。结果:与非冠心病组对应各时间点比较,AMI择期PCI组、AMI急诊PCI组MDA浓度明显升高(P<0.05);非冠心病组MDA浓度与UA组比较无统计学差异。AMI择期PCI组、AMI急诊PCI组及UA组与非冠心病组比较,各时间点AOPP浓度明显升高(P<0.05);AMI择期PCI组各时间点AOPP浓度较AMI急诊PCI组高(P<0.01)。结论:AMI患者血浆中MDA浓度显著升高,氧化应激产生的脂质过氧化过程可能是ACS病理生理发生发展中的重要环节。Objective To examine the malondialdehyde （MDA） and advanced oxidation protein products （AOPP） in patients with acute coronary syndrome （ACS） and discuss the relationship between lipid peroxidate with the development of ACS. Methods The collected 73 patients with acute myocardial infarction （AMI） （including 46 selective PCI patients ＆ 27 emergency PCI patients） ,49 patients with unstable angina pectoris（UA） and 21 patients with non-coronary artery disease （non-CAD） all underwent coronary angiography. Plasma were collected at immediately, post-24 hours and post-48 hours after patients were recruited. MDA was measured with TBA methods and AOPP was determined by measurements of optical density via spectrophotometry. Results Compared with normal group （non- CAD） ,significantly higher plasma MDA were seen in all patients with AMI （P 〈 0.05 ）, including selective PCI and emergency PCI patients, but it had no difference between the patients with UA and patients with non-CAD （ P 〉 0.05 ）. Compared with normal group （non-CAD）, significantly higher plasma AOPP were detected in the patients with AMI （ including selective PCI and emergency PCI group） ＆ UA （ P 〈 0.05 ）. Comparing emergency PCI group, significantly higher plasma AOPP also existed in the selective PCI group （ P 〈 0.01 ）. Conclusion Lipid peroxidation significantly increases in patients with AMI and it may have important effects in development of ACS.

关 键 词：急性冠脉综合征 脂质过氧化物 丙二醛 晚期蛋白氧化产物 氧化应激 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]