硒对急性心肌梗塞病人红细胞变形能力的影响及机制探讨  

EFFECT AND MECHANISM OF SELENIUM ON ERYTHROCYTE DEFORMABILITY IN ACUTE MYOCARDIAL INFARCTION PATIENTS

作　　者：刘成玉[1,2,3,4] 曲彦[1,2,3,4] 杨健[1,2,3,4] 王秀丽[1,2,3,4] 谭润鸾[1,2,3,4] 

机构地区：[1]青岛医学院诊断学教研室 [2]青岛市市立医院内科 [3]青岛市第二人民医院内科 [4]青岛医学院生物化学教研室

出　　处：《青岛医学院学报》1997年第1期22-24,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的探讨硒（Ｓｅ）对急性心肌梗塞（ＡＭＩ）病人红细胞变形能力（ＥＤ）的影响及其机制。②方法检测了４２例ＡＭＩ病人和３７例健康人红细胞滤过指数（ＥＦＩ）、红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶、谷胱甘肽过氧化物酶（ＧＳＨ－ｐｘ）活性和脂质过氧化物（ＬＰＯ）的变化，同时观察了硒在体外对ＡＭＩ病人ＥＦＩ，Ｎａ＋－Ｋ＋－ＡＴＰ酶、ＧＳＨ－ｐｘ和ＬＰＯ的影响。③结果ＡＭＩ病人ＥＦＩ，ＬＰＯ明显增高，Ｎａ＋－Ｋ＋－ＡＴＰ酶和ＧＳＨ－ｐｘ活性明显降低，与对照组比较差异均有极显著性（ｔ＝４．２０６～４．９５２，Ｐ均＜０．００１）；ＡＭＩ病人红细胞与Ｓｅ在体外孵育２４ｈ后，ＥＦＩ与ＬＰＯ明显降低，Ｎａ＋－Ｋ＋－ＡＴＰ酶和ＧＳＨ－ｐｘ活性明显增高，与孵育前组比较差异均有极显著性（ｔ＝３．５０５～４．５１７，Ｐ＜０．００１），与对照组孵育前后组比较差异均无显著性（ｔ＝１．３６５～１．８４２，Ｐ均＞０．０５）。④结论Ｓｅ具有改善和提高ＡＭＩ病人ＥＤ的作用，其机制与增强红细胞膜ＡＴＰ酶和ＧＳＨ－ｐｘ活性有关。Objective To study the effects and mechanisms of selenium on erythrocyte deformability(ED) in patients with acute myocardial infarction(AMI). Methods The erythrocyte filtration index(EFI), erythrocyte membrane Na + K + ATPase, glutathione peroxidase(GSH px) and lipid peroxide(LPO) were measured in 42 patients and 37 healthy subjects, meanwhile the effect of selenium on EFI, Na + K + ATPase, GSH px and LPO in AMI patients were observed in vitro. Results The EFI and LPO were significantly higher, Na + K + ATPase and GSH px were significantly lower in patients than those in controls( t=4.206￣ 4.952, P <0 001); AMI patients erythrocytes were incubated with selenium for 24 hours, the EFI and LPO were markedly lower, Na + K + ATPase and GSH px were markedly higher than those before the incubation( t=3.505￣4.517,P <0 001), but there were no significant differences compared with the healthy subjects before and after the incubation( t=1.363￣1.842,P >0 05). Conclusion Selenium can improve the ED in AMI patients, and the mechanism may be related to the enchancement of erythrocyte membrane ATPase and GSH px activity.

关 键 词：心肌梗塞 AMI 红细胞变形能力 硒 GSH-PX 

分 类 号：R542.22[医药卫生—心血管疾病]