急性冠脉综合征患者高密度脂蛋白亚组分的抗炎、抗氧化功能研究  

Anti-inflammatory and antioxidant functions of high-density lipoprotein subclasses in patients with acute coronary syndrome

作　　者：谭迎[1] 田迪[1] 赖文岩[1] 郭志刚[1] 

机构地区：[1]南方医科大学附属南方医院心血管内科,广州510515

出　　处：《解放军医学杂志》2013年第2期129-132,共4页Medical Journal of Chinese People's Liberation Army

基　　金：广东省自然科学基金(10151051501000073);教育部高等学校博士学科点专项科研基金(20104433110006)~~

摘　　要：目的评估急性冠脉综合征(ACS)患者高密度脂蛋白(HDL)亚组分(HDL2和HDL3)的抗炎、抗氧化功能,明确ACS患者HDL亚组分是否发生了失功能改变。方法纳入2011年1月-2012年1月在南方医院心内科住院的ACS患者(ACS组)及同期体检的健康者(对照组)各40例。分别检测两组血脂4项、超敏C反应蛋白(hsCRP)、HDL亚组分对氧磷酶-1(PON1)活性、脂氢过氧化物(LOOH)水平及炎症指数。结果 ACS组血清低密度脂蛋白胆固醇(LDL-C)水平及hsCRP浓度均较对照组明显升高(P<0.01)。与对照组比较,ACS组HDL亚组分PON1活性均明显下降(P<0.001),炎症指数及LOOH水平则均较对照组明显升高(P<0.001);两组HDL3中LOOH水平均较HDL2中LOOH水平明显升高(P<0.05或P<0.001);对照组内HDL3炎症指数较HDL2明显升高(P<0.001),而ACS组HDL2和HDL3炎症指数差异无统计学意义(P>0.05)。结论 ACS患者HDL亚组分发生失功能改变,其抗氧化能力减弱,具有促炎作用;成熟的HDL2可能较未成熟的HDL3具有更强的抗炎、抗氧化功能,从而能发挥更好的心血管保护作用。Objective To assess the anti-inflammatory and antioxidant functions of high-density lipoprotein （HDL） subclasses （HDL2 and HDL3） in patients with acute coronary syndrome （ACS）, and to elucidate whether incapacitation of HDL subclasses occurred in ACS patients. Methods Forty ACS patients hospitalized in Nanfang Hospital from Jan. 2011 to Jan. 2012 （ACS group）, and 40 subjects simultaneously receiving health examination （control group） were enrolled in present study. Plasma lipid and hypersensitive C reactive protein （hs-CRP） levels, HDL subclasses inflammatory index （HII）, paraoxonase-1 （PON1） activity and lipid hydroperoxide （LOOH） levels in both groups were measured. Results The low-density lipoprotein cholesterol （LDL-C） and hs-CRP levels were higher in ACS group than in control group （P〈0.01）. Compared with control group, the PON1 activity of HDL subclasses declined significantly （P〈0.001）, but HII and HDL-LOOH levels were elevated in ACS group （P〈0.001）. In both groups, the LOOH level was higher in HDLs than in HDL2 （P〈0.05 or P〈0.001）. In control group, the HII level was higher in HDLs than in HDL2 （P〈0.001）, while no significant difference was found between HDL2 and HDL3 in ACS group （P〉0.05）. Conclusions The incapacitation of HDL subclasses may occur in ACS patients, with an attenuated antioxidant ability and accentuated proinflammatory function. Mature HDL2 possesses better anti-inflammatory and antioxidant function than HDLs, thus playing a better cardioprotective effect.

关 键 词：急性冠脉综合征 高密度脂蛋白 对氧磷酶-1 炎症指数 脂氢过氧化物 

分 类 号：R541.4[医药卫生—心血管疾病]