冠状微血管痉挛性心绞痛患者血内源性一氧化氮合酶抑制物的变化  

The Changes of NG-Dimethyl-L-Arginine in Patients With Coronary Microvascular Spasm Angina

作　　者：黄新金[1] 李菊香[1] 颜素娟[1] 苏海[1] 罗伟[1] 程晓曙[1] 吴清华[1] 吴延庆[1] 

机构地区：[1]南昌大学第二附属医院 心内科,江西省南昌市330006

出　　处：《中国循环杂志》2007年第2期100-102,共3页Chinese Circulation Journal

基　　金：江西省卫生厅科研项目G010607

摘　　要：目的:探讨冠状微血管痉挛性心绞痛(X综合征)发病机制。方法:收集我院2002年6月～2005年6月住院患者中诊断为X综合征患者20例,排除高血压病、糖尿病、肥厚型心肌病等疾病。以年龄、性别相匹配的20例健康人作为正常对照组。检测所有受试者静脉血内源性一氧化氮合酶(NOS)抑制物—不对称二甲精氨酸(ADMA)、一氧化氮(NO)、内皮素(ET-1)和超氧化物歧化酶(SOD),丙二醛(MDA)、血脂、血糖和纤维蛋白原等指标。结果:①与正常对照组相比,X综合征组ADMA、内皮素水平明显升高,一氧化氮水平明显降低,有显著性差异(P均<0.05),ADMA与内皮素/一氧化氮呈明显的正相关,r=0.709。②X综合征组丙二醛明显高于正常对照组,超氧化物歧化酶则明显低于正常对照组(P均<0.05)。③两组胆固醇、甘油三脂及低密度脂蛋白、血糖和纤维蛋白原水平无明显差异。结论:X综合征患者存在明显的冠状动脉血管内皮功能不良,且这种内皮功能异常与内源性一氧化氮合酶抑制剂ADMA有关。同时氧化应激在X综合征的发病中也起着重要的作用。Objective ：To investigate the change of asymmetric NG, NG-dimethyl-L-arginine（ADMA） in patients with coronary microvascular spasm angina（CMSA） ,and elucidate the possible mechanism of CMSA. Methods：We screened 20 hospitalized CMSA patients from June 2002 to June 2005. The diagnosed standards of CSMA were typical angina pectoris, positive exercise stress test and normal coronary angiograpby, other diseases were excluded, such as hypertension, diabetes and hypertrophic cardiomyopathy. We selected 20 normal persons with similar age and same sex as control. The levels of ADMA, NO, ET-1, SOD, MDA, blood lipids, glucose, blood viscosity, fibrinogen were measured in both groups. Results：①Compared with control,in CMSA group the levels of ADMA,ET-1 and MDA were significantly increased and the levels of NO and SOD were significantly decreased. ADMA was positive correlated with the ratio of ET-1/NO. ②There were statistical significances between control and CMSA group for levels of SOD and MDA. ③There were no differences for levels of blood lipids （ TC,TG, LDL, HDL-C, Lpa）, glucose, blood viscosity and fibrinogen between two groups. Conclusions：This study shows endothelial dysfunction in the patients with CMSA is associated with the increase of ADMA. Oxide stress may play an important role in CMSA.

关 键 词：冠状微血管痉挛性心绞痛 内皮功能 不对称二甲精氨酸 

分 类 号：R541[医药卫生—心血管疾病]