冠心病患者血清非对称二甲基精氨酸水平与冠状动脉狭窄程度的相关性  

Correlation between Serum Asymmetric Dimethylarginine Level and Severity of Coronary Atherosclerosis in Patients with Coronary Artery Heart Disease

作　　者：黄日茂[1] 蒋海河[1] 罗万俊[1] 林国强[1] 李迎秋[2] 

机构地区：[1]中南大学湘雅医院心胸外科,湖南省长沙市410008 [2]湖南中医药大学基础医学院,湖南省长沙市410007

出　　处：《中国动脉硬化杂志》2008年第7期549-552,共4页Chinese Journal of Arteriosclerosis

基　　金：湖南省自然科学基金(02jjy2053)

摘　　要：目的探讨血清非对称二甲基精氨酸与冠状动脉狭窄程度及冠心病病情的关系及其临床意义。方法选取75例行冠状动脉造影患者,并根据冠状动脉造影结果和临床表现分为稳定型心绞痛组(n=15)、不稳定型心绞痛组(n=23)、急性心肌梗死组(n=20)和对照组(n=17)。所有患者分别进行病史采集,并检测血脂、非对称二甲基精氨酸水平,应用Gensini积分系统评价患者的冠状动脉粥样硬化病变程度。分析血清非对称二甲基精氨酸水平与年龄、性别构成比、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及冠状动脉病变程度的相关性。结果与对照组血清非对称二甲基精氨酸水平(3.81±0.48μmol/L)相比,稳定型心绞痛组(4.82±0.50μmol/L)、不稳定型心绞痛组(5.52±0.55μmol/L)和急性心肌梗死组(6.03±1.13μmol/L)均明显升高,且差异有统计学意义(P<0.01);不稳定型心绞痛组和急性心肌梗死组血清非对称二甲基精氨酸明显高于稳定型心绞痛组,差异具有统计学意义(P<0.01)。急性心肌梗死组血清非对称二甲基精氨酸与不稳定型心绞痛组相比,虽有升高的趋势,但差异不具有统计学意义(P=0.279)。冠心病各亚组Gensini评分均明显高于对照组(Gensini评分为0),差异有统计学意义(P<0.01);稳定型心绞痛组Gensini评分(17.79±1.86)分别与不稳定型心绞痛组(38.05±4.46)和急性心肌梗死组(40.62±3.80)比较,差异有统计学意义(P<0.01)。血清非对称二甲基精氨酸水平与总胆固醇和低密度脂蛋白胆固醇呈正相关(P<0.01),而与年龄、性别构成比、甘油三酯、高密度脂蛋白胆固醇无显著相关性(P>0.05)。血清非对称二甲基精氨酸水平与冠状动脉狭窄程度Gnesini评分有明显相关性(r=0.704,P=0.000)。结论冠心病患者的血清非对称二甲基精氨酸水平与冠状动脉狭窄程度和冠心病病情的严重程度相关,监测血清非对称二甲基精氨�Aim To investigate the correlation between endogenous inhibitor of nitric oxide synthase （NOS） asyrmmetric dimethylarginine （ADMA） in patients with coronary artery heart disease and severity of coronary atheroscleresis. Methods A total of 75 patients were enrolled and divided into four groups： stable angina pectoris group （SAP, n = 15）, trustable angina pectoris group （UAP, n=23）, acute myocardial infarction group （AMI, n=20） and control group （n=17）. Clinical history was collected and total cholesterol （T C）, triglyceride （TG）, low density hpoprotein cholesterol （LDLC）, high density lipoprpmtein cholesterol （HDLC） and ADMA levels were determined. Coronary artery lesion was evaluated by Gensinis coring system. Relevance of ADMA to age, sex proportion, TC, TG, LDLC, HDLC, and coronary artery Gensinis coring was analyzed. Results Compared with the control group （3.81 〉±0.48 μmol/L）, the serum ADMA level of the SAP group （4.82±0.50 μmol/L）, UAPgroup（5.52±0.55μmol/L）andAMIgroup（6.03±1.13μmol/L） inereasedsignificantly （P〈0.01）. Thesemm ADMA level of the UAP group and AMI group were higher than that of the SAP group （ P 〈 0.01 ）. The difference of the serum ADMA level between the UAP group and AMI group wasn＇ t statistically significant （ P = 0. 279）. Gensinis coting of the control group was significantly different from the other three groups （ P 〈 0.01 ）. Gensinis coring of the SAP group （ 17.79 ± 1.86） was significantly lower than those of the UApgroup （38.05±4.46） and AMI group （40.62±3.80） （P〈0.01）. Therewasnosignificant differenco of Gensinis earing between the UAP group and AMI group （ P 〉 0.05）. Significant correlation between ADMA level and TC, LDLC levels, and Gensinis coring were found （ P 〈 0.01 ）. Them was no significant correlation between ADMA level and age, sex proportion, TG and HDLC levels （ P 〉 0.05）. Conclusions The serum ADMA is positively correlative to the degree of c

关 键 词：内科学 非对称二甲基精氨酸 冠状动脉狭窄 心绞痛 不稳定型 心绞痛 稳定型 心肌梗 死 急性 患者 冠心病 

分 类 号：R5[医药卫生—内科学]