急性冠状动脉综合征患者血浆蛋白氧化产物升高的机制及意义  

The Role of Advanced Oxidation Protein Products in 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,江苏省南京市210009

出　　处：《中国动脉硬化杂志》2006年第11期983-985,共3页Chinese Journal of Arteriosclerosis

基　　金：江苏省卫生厅开放课题(WK0510)

摘　　要：目的通过检测急性冠状动脉综合征患者体内晚期蛋白氧化产物、丙二醛的水平来探讨氧化应激损伤与冠状动脉粥样硬化斑块发生发展的关系。方法入选73例急性心肌梗死(46例择期和27例急诊冠状动脉介入治疗)、49例不稳定型心绞痛及21例非冠心病患者,均经造影证实。于入院即刻2、4 h和48 h采集外周静脉血标本。紫外荧光光度法测定晚期蛋白氧化产物浓度;硫代巴比妥酸光度法测定丙二醛浓度。结果晚期蛋白氧化产物浓度在急性心肌梗死择期冠状动脉介入治疗组、不稳定型心绞痛组较非冠心病组明显升高(P<0.05);急性心肌梗死择期冠状动脉介入治疗组各时间点晚期蛋白氧化产物浓度较急性心肌梗死急诊冠状动脉介入治疗组高(P<0.01);急性心肌梗死择期冠状动脉介入治疗组与不稳定型心绞痛组差异无统计学意义(P>0.05);急性心肌梗死择期冠状动脉介入治疗组晚期蛋白氧化产物浓度与低密度脂蛋白呈正相关[r=0.370(入院即刻)、r=0.422(入院24 h)、r=0.559(入院48 h)]。与非冠心病组对应各时间点丙二醛浓度比较,急性心肌梗死择期冠状动脉介入治疗组、急诊冠状动脉介入治疗组升高(P<0.05),而与不稳定型心绞痛组比较无统计学差异。结论急性冠状动脉综合征患者血浆中晚期蛋白氧化产物、丙二醛浓度显著升高。氧化应激可能是急性冠状动脉综合征发生发展过程中的重要环节,晚期蛋白氧化产物、丙二醛是反映体内氧化应激水平较好的血清学指标。Aim To examine the advanced oxidation protein products（AOPP） and malondialdehyde（MDA） in patients with acute coronary syndrome（ACS） and discuss the relationship between oxidative stress and the development of atherosclerosis（As）. Methods Plasma were collected in 73 acute myocardial infarction（AMI） patients including 46 patients undergone selective percutaneous coronary intervention（PCI）and 27 patients undergone emergency PCI,49 unstable angina pectoris（UAP） patients and 21 non-coronary artery disease（non-CAD）patients. An cases were undone coronary sngiography （CAG）.Plasma were collected immediately, post-24 hours and post-48 hours after patients were recruited. AOPP were determined by of optical density （OD） via spectrophotometry, and MDA was measured with TBA methods. Resultsl Com pared with normal group （without CAD）, plasma AOPP were sigtdflcantly higher in AMI （selective PCI） and UAP patients （ P 〈 0.05）. Significant difference also existed between selective PCI group and emergency PCI group in AMI patierts（P〈0.01）. AOPP levels d UAP patients were significantlly decreased after 48 horns （ P〈0.05） ; Pearson correlation analysis showed that AOPP was poeitively correlated to low density lipopmtein cholesteroll（LDLC） in AMI patients （P〈0.01）. Compared with nor- real group （ without CAD）, plasma MDA were significantly higher in alll AMI patients （P〈0.05）. Conclusons Oxidative stress may be an importart step in development of ACS. AOPP and MDA may be as good markers in ACS patients.

关 键 词：内科学 急性冠状动脉综合征 蛋白氧化产物 丙二醛 氧化应激 低密度脂蛋白 

分 类 号：R5[医药卫生—内科学]