急性冠脉综合征氧化应激损伤及与低密度脂蛋白的相关性  

Oxidation stress and its relationship with low density lipoprotein 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,江苏南京市210009

出　　处：《心血管康复医学杂志》2007年第5期452-455,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：通过检测急性冠脉综合征（ACS）患者体内晚期蛋白氧化产物（AOPP）、低密度脂蛋白（LDL）、丙二醛（MDA）的水平来探讨氧化应激损伤与急性冠脉综合症发生发展的关系。方法：入选73例急性心肌梗塞（AMI）（含46例择期PCl和27例急诊PCI）、49例不稳定性心绞痛（UAP）及21例非冠心病患者,均经造影证实。于入院即刻、24 h和48 h采集外周静脉血标本。紫外荧光光度法测定AOPP浓度;硫代巴比妥酸（TBA法）光度法测定MDA浓度等,进行Pearson相关分析。结果：AOPP浓度在AMI组（AMI择期组较急诊PCI组更高）,UAP组明显升高（P〈0.05）;UAP组入院48 h与入院即刻比较AOPP浓度明显下降（P〈0.05）;AMI择期PCI组AOPP浓度与LDL-C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）。MDA浓度：与非冠心病组对应各时间点比较,AMI择期PCI组、AMI急诊PCI组的均升高（P〈0.05-〈0.01）,而UAP组无显著改变（P〉0.05）。结论：ACS患者血浆中AOPP、MDA浓度显著升高;AMI患者中AOPP水平与LDL呈止相关。氧化应激可能是AS发生发展过程中的重要环节,并与脂代谢失调有一定的相关性。Objective： To examine the advanced oxidation Protein products （AOPP）, malondialdehyde （MDA） and low density lipoprotein （LDL） in patients with acute coronary syndrome （ACS） and discuss the relationship between oxidative stress and the development of ACS. Methods： Plasma collected in 73 acute myocardial infarction （AMI） patients （inlude 46 patients underwent selective PC1 ＆ 27 patients underwent emergency PC1）, 49 unstable angina pectoris （UAP） patients and 21 non-coronary artery disease （non-CAD） patients. All cases were underwent coronary angiography （CAG）. Plasma collected immediately, post 24 h and 48 h after patients were recruited. AOPP were determined by measurements of optical densifty （OD） via spectrophotometry and MDA measured with TBA methods. Results： Compared with normal group （without CAD）, significantly higher plasma AOPP were detected in AM1 （selective PC1 and emergency PCI） ＆ UAP patients （P〈0. 05）. Significant difference also exists between selective PC1 group and emergency PCI group in AM1 patients （P〈0. 01）. AOPP level of UAP patients decreased significantly after 48 h （P〈 0. 05） ; Pearson correlation analysis showed that AOPP was positively correlated to LDL-C in selected AMI patient. Compared with normal group （without CAD）, significantly higher plasma MDA were seen in all AM1 patients （P〈 0. 05-〈0. 01）, but the MDA no significant change in UAP patients （P〉0. 05）. Conclusion： Oxidative stress may be an important step in development of ACS and may be relationship with abnormal lipid metabolism.

关 键 词：冠状动脉疾病 氧化性应激 晚期蛋白氧化产物 

分 类 号：R541.409[医药卫生—心血管疾病]