冠心病患者血内源性一氧化氮合酶抑制物变化的意义  

Role of Change of ADMA in Patients with Coronary Heart Disease

作　　者：黄新金 李菊香[2] 

机构地区：[1]佛山市顺德区桂洲医院急诊科,广东佛山528305 [2]南昌大学第二附属医院心内科,南昌330006

出　　处：《实用临床医学（江西）》2008年第8期11-13,共3页Practical Clinical Medicine

摘　　要：目的测定冠状动脉粥样硬化性心脏病（coronary heart disease，CHD）患者血中的内源性一氧化氮合酶抑制物——不对称二甲精氨酸（ADMA）等指标，以进一步探讨冠心病患者冠脉血管内皮功能损伤的机制。方法收集本院2002年6月-2005年6月冠状动脉造影结果有冠脉单支或多支狭窄70％以上20例，作为冠心病组。并以年龄、性别相匹配的20例健康人作为对照组。所有应试者取静脉血测定ADMA、一氧化氮（NO）、内皮素（ET-I）、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，并进行比较。结果（1）与正常对照组比较，冠心病组ADMA、ET-1和MDA水平明显升高，NO和SOD水平明显降低，有显著性差异（P均〈0．05），ADMA与NO呈明显的负相关（r=-0．53，P〈0．01）。（2）冠心病组血胆固醇、甘油三脂、低密度脂蛋白、高密度脂蛋白、脂蛋白α（TC、TG、LDL、HDL-C、Lpa）水平多数有异常，而血糖和纤维蛋白原水平，2组无差异。结论冠心病患者存在明显的内皮功能异常，与内源性一氧化氮合酶抑制剂ADMA有关；同时氧化应激在冠状动脉粥样硬化性心脏病的发病中也起重要作用。Objectives To investigate the change of asymmetric Dimethylarginine （ADMA） in patients with coronary heart disease（CHP）, and to elucidate the possible mechanism of coronary heart disease. Methods Twenty hospitalized CHD patients were screened from June 2002 to June 2005. The diagnosis standards of CHD were more than 70% stenosis of single or multiple coronary arteries by angiography as CHD group,and 20 normal persons with matching age and sex as control. The levels of ADMA,NO,ET-1,SOD,MDA, blood lipid, blood glucose,fibrinogen were measured respectively. Results （1）Compared with control,the levels of ADMA, ET-1 and MDA were significantly increased and the levels of NO and SOD were significantly decreased in CHD group （P 〈 0. 05 respectively）. ADMA was negative correlated with concentration of NO （r=-0.53, P（0.01） ; （2）The levels of blood lipid（TC, TG, LDL, HDL-C, Lpa） in most patients of CHD were abnormal. There were no differences for the levels of blood glucose, blood viscosity,and fibrinogen between two groups. Conclusion This study shows endothelial dysfunction in the patients with CHD is associated with the increase of ADMA. Oxide stress may play an important role in CHD.

关 键 词：冠状动脉粥样硬化性心脏病 内皮功能 不对称二甲精氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]