硫化氢及一氧化氮气体信号分子在冠心病发病中的作用及其与冠脉病变类型的关系  

Pathophysiological significance of hydrogen sulfide and nitric oxide in coronary heart disease and its relationship with coronary artery lesion type

作　　者：吴宏超[1] 李志樑[1] 傅强[1] 华经海[1] 靳文[1] 

机构地区：[1]南方医科大学珠江医院心血管内科,广东广州510282

出　　处：《热带医学杂志》2011年第8期910-913,共4页Journal of Tropical Medicine

基　　金：广东省科技计划项目(2009B030801206);广东省自然科学基金项目(95151051501000056)

摘　　要：目的研究硫化氢(H2S)及一氧化氮(NO)气体信号分子在冠心病患者中的变化及其与冠脉病变类型的关系,探讨其在冠心病发病中的病理生理意义。方法冠心病组40例,造影正常对照组17例,冠心病患者根据临床表现和辅助检查,分为稳定性心绞痛组、不稳定性心绞痛组、急性心肌梗死组;根据冠脉造影结果,再分为单支病变组、双支病变组、三支病变组。采用硫敏感法测定所有研究对象血浆H2S含量,并用Greiss法测定血浆NO含量,分析不同亚型冠心病患者和对照者血浆H2S、NO含量的差异及H2S、NO与不同冠脉病变类型的关系。结果冠心病患者血浆H2S、NO含量为(26.10±14.27)、(44.25±9.71)μmol/L,远低于冠脉造影正常对照组的(51.74±11.94)、(53.94±4.36)μmol/L,两组比较差异均有统计学意义(P<0.01);在冠心病各常见亚型中,不稳定性心绞痛患者和急性心肌梗死患者血浆H2S含量分别为(23.60±14.41)μmol/L、(19.98±7.52)μmol/L,明显低于稳定性心绞痛患者的(38.41±14.53)μmol/L;急性心肌梗死患者血浆NO含量为(39.71±6.03)μmol/L,明显低于稳定性心绞痛患者的(44.25±9.71)μmol/L(P<0.05)。冠脉双支和多支病变组血浆H2S含量分别为(16.91±7.98)、(18.39±7.78)μmol/L,差异无统计学意义(P>0.05),但均明显低于单支病变组的(33.04±15.01)μmol/L(P<0.05);不同支数病变冠心病患者血浆NO含量差异无统计学意义(P>0.05)。冠脉血管有闭塞组其血浆H2S、NO含量明显低于单纯狭窄组(P<0.05)。结论 H2S与NO的代谢异常可能参与了冠心病的发病过程,其中血浆H2S含量的高低与冠脉病变类型相关。Objective To investigate the changes and expression of plasma H2S and NO levels in patients with coronary heart disease （CHD） and its relationship with the type of coronary artery lesion.Methods Blood samples from the femoral artery of 40 patients with coronary heart disease and with coronary angiography indicating coronary stenosis,and 17 healthy control subjects were analyzed.The levels of H2S and NO were measured by ion chromatography or gas chromatography.Results The levels of plasma H2S and NO were significantly lowered in CHD patients than in healthy control subjects （P0.01）.The levels of plasma H2S in unstable angina patients （UAP） and acute myocardial infarction patients （AMI） were lower than the stable angina patients （SAP,P0.05）.The difference in the level of plasma NO between AMI and SAP was significant （P0.05）.The level of plasma H2S in CHD patients with double-vessel or multi-vessel lesions was significantly lower than the patients with single-vessel lesions （P0.01）,but not in patients with double-vessel or multi-vessel lesions （P0.05）.The levels of plasma H2S and NO levels were significantly lower in CHD patients with coronary artery occlusion than with the patients with simple stenosis subjects （P0.05）.Conclusion H2S and NO may be involved in the pathogenesis of coronary heart disease.The level of plasma H2S is correlated with the severity of coronary artery disease.

关 键 词：冠心病 硫化氢 一氧化氮 气体信号分子 

分 类 号：R541.4[医药卫生—心血管疾病]