老年急性冠脉综合征患者E-选择素与氧化应激的相关性研究  

Research on Relationship Between E-selectin and Oxidative Stress in Aged Patients with Acute Coronary Syndrome

作　　者：黄湘[1] 谭德安[2] 谭家余[1] 钟锋[1] 李舟文[1] 

机构地区：[1]嘉应学院医学院基础部病原教研室,广东梅州514031 [2]中国人民解放军国防科技大学医院检验科,湖南长沙410007

出　　处：《实用预防医学》2009年第3期683-686,共4页Practical Preventive Medicine

摘　　要：目的通过检测血清可溶性E-选择素(sEsel)、晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、超氧化物歧化酶(SOD)和氧化低密度脂蛋白(ox-LDL)水平,探讨老年急性冠脉综合征(ACS)患者sEsel与氧化应激的相关性。方法选择老年ACS患者共70例,其中非ST段抬高ACS(NSTEMI/UAP)组40例,ST段抬高ACS(STEMI)组30例作为研究对象,健康自愿者36例作为对照。采用ELISA双抗体夹心法检测sEsel和ox-LDL水平,分光光度计法检测AOPP浓度,硫代巴比妥酸法和黄嘌呤氧化酶法分别测定MDA含量和SOD活力。采用双变量相关分析评价sEsel与氧化应激相关指标的相关性,并记录4周内所有患者的病情转归情况。结果老年ACS中,NSTEMI/UAP组和STEMI组的sE-sel、AOPP、MDA、SOD和ox-LDL水平均明显高于健康对照组(P<0.01),其中NSTEMI和UAP亚组间各项指标差异无统计学意义(P>0.05)。STEMI组sEsel、AOPP和ox-LDL水平均高于NSTEMI/UAP组(P<0.05),而MDA、SOD水平两组间差异无统计学意义(P>0.05)。STEMI组中冠状动脉单支病变亚组与多支病变亚组相比,各项指标均明显增高(P<0.05)。双变量相关分析显示老年ACS的sEsel与AOPP(r=0.496,P=0.000)和ox-LDL(r=0.342,P=0.000)密切相关。另外发现sEsel浓度高者病情转归及预后差,低者病情转归及预后良好。结论老年ACS发生时具有明显的氧化应激反应,sEsel的增高可能与AOPP和ox-LDL有关。sEsel对病情转归有一定预测意义。Objective To explore the relationship between soluble E - selectin （sEsel）.andoxidative stress by detect- ing the serum concentrations of sEsel, advanced oxidation protein products （AOPP）, malonaldehyde （MDA）, serum superox- ide dismutase （SOD）, and oxidized low density lipoprotein （ox- LDL） in aged patients with acute coronary syndrome （ACS）. Methods The serum concentrations of sEsel and ox- LDL were measured by using double antibody sandwich ELISA, AOPP by spectrophotometer, MDA by thiobarbituric acid method, and SOD activity by xanthine oxidase method in 40 aged patients with non- ST elevation myocardial infarction/unstable angina pectoris （NSTEMI/UAP）, 30 aged patients with ST ele- vation myocardial infarction （STEMI）, and 36 healthy controls （HC）. Bivariate analysis was used to explore the relationship between sEsel and oxidative stress. The disease development of aged ACS was followed up for four weeks. Results Compared with HC group, serum levels of sEsel, AOPP, MDA, SOD, and ox - LDL in NSTEMI/UAP group and STEMI group increased significantly （P〈 0.0l ）, among which, no difference was found between NSTEMI subgroup and UAP subgroup in all detected indexes （P 〉0.05）. There were significant differences in the serum concentrations of sEsel, AOPP and ox - LDL be- tween STEMI group and NSTEMI/UAP group （P〈 0.05）, but no difference was found in MDA content and SOD activity （P 〉 0.05）. In STEMI group, all detected indexes of single vessel disease subgroup were significantly higher than those of multiple vessel disease subgroup （P〈 0.05）. Bivariate analysis showed that there were close relationships between sEsel and AOPP （r = 0. 496, P = 0. 000） or ox- LDL （r = 0. 342, P = 0. 000）. The result of follow up showed that the outcome of aged ACS was closely related to the concentration of sEsel. Conclusions An obvious oxidative stress reaction is happened in the on- set of aged ACS. The increase of sEsel may be resulted from the effect of AOPP

关 键 词：老年 急性冠脉综合征 可溶性E一选择素 氧化低密度脂蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]