急性心肌梗死患者外周血单个核细胞NADPH氧化酶与左心室重构的关系  

Relationship between NADPH oxidase of peripheral blood mononuclear cells and left ventricular remodeling in patients with acute myocardial infarction

作　　者：刘建云[1] 徐鹏[1] 李红霞[1] 张蕾[1] 李勋[1] 

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《临床心血管病杂志》2013年第3期214-217,共4页Journal of Clinical Cardiology

基　　金：苏州市科技计划项目(No:SYS201028)

摘　　要：目的:探讨急性心肌梗死(AMI)患者外周静脉血单个核细胞尼克酰胺腺嘌呤二核苷酸磷酸(NAD-PH)氧化酶与左室重构的关系。方法:选择2010-12-2011-08住院治疗的77例AMI患者(AMI组)及同期住院的24例阵发性室上性心动过速患者(对照组),于入院第2天采空腹静脉血检测生化指标、丙二醛(MDA)、单个核细胞超氧阴离子(O2-)浓度及NADPH氧化酶活性;行超声心动图检查计算左室舒张末期容积指数(LVED-Vi)、射血分数(EF)和左室质量指数(LVMI);随访47例AMI患者发病后6个月时的上述各指标。分析AMI后上述指标的变化及其与LVMI的关系。结果:入院时,AMI组与对照组LVMI[(111.09±23.45)g/m2∶(80.94±16.28)g/m2],MDA浓度[(6.17±2.76)nmol/ml∶(2.81±1.70)nmol/ml],O2-浓度[(11.20±5.95)RLU/mg蛋白∶(6.26±2.23)RLU/mg蛋白],及NADPH氧化酶活性[(14.13±4.48)RLU/mg蛋白∶(7.47±2.62)RLU/mg蛋白]均差异有统计学意义(均P<0.01)。47例AMI患者随访6个月时,LVMI[(123.26±31.98)g/m2]显著高于入院时[(108.07±24.35)g/m2](P<0.05),MDA浓度[(3.58±1.26)nmol/ml]较入院时[(6.11±2.89)nmol/ml]显著降低(P<0.01),O2-浓度[(6.86±2.75)RLU/mg蛋白]较入院时[(11.95±6.60)RLU/mg蛋白]显著降低(P<0.01),NADPH氧化酶活性[(8.38±3.76)RLU/mg蛋白]较入院时[(14.17±3.88)RLU/mg蛋白]显著降低(P<0.01)。随访6个月时的MDA浓度、O2-浓度和NADPH氧化酶活性与LVMI呈正相关(r分别为0.32、0.55及0.77,P<0.01)。结论:NADPH氧化酶活性增加导致的氧化应激在AMI后左室重构的发展过程中起重要作用。Objective： To investigate the relationship between nicotinamide adenosine dinucleotide phosphate oxidase （NADPH oxidase） of peripheral blood mononuclear ceils and left ventricular remodeling in patients with acute myocardial infarction （AMI）. Method： From December 2010 to August 2011, 77 hospitalized patients with AMI were enrolled as AMI group, and 24 hospitalized patients with paroxysmal supraventricular tachycardia as control group . On the second day after admission , fasting blood was drawn to measure the levels of biochemical markers, malondialdehyde （MDA）, superoxide （02 ） and the activity of NADPH oxidase of mononuclear cells. All patients had doppler echocardiography to calculate left ventricular end-diastolic volume index （LVEDVi）, ejection fraction （EF） and left ventricular mass index （LVMI）. All of these indexes were meas.ured again in 47 AMI patients at follow-up after 6 months. The changes of the above indexes after AMI and their relationships with LVMI were analyzed. Result： At admission, LVMI in AMI group E （ 111.09 ± 23.45） g/m2 ] was significantly higher than control group E（80.94 ± 16.28）g/m2] （P〈0.01）. There were significant differences between AMI group and control group in concentration of MDA [（6. 17±2.76）nmol/ml vs （2.81±1. 70）nmol/ml], 02 [（11.20＋ 5.95）RLU/mg protein vs （6.26±2.23） RLU/mg protein], and the activity of NADPH oxidase [（14.13±4.48） RLU/mg protein vs （7.47±2.62）RLU/mg protein] （all P〈0.05）. At follow-up in 47 AMI patients compared with at admission, LVMI significantly increased [（ 123.26 ＋ 31.98） g/m2 vs （ 108.07 ± 24.35） g/m2], the MDA concentration decreased L（3.58± 1.26）nmol/ml vs （6.11±2.89）nmol/ml], the concentration of O2^- lowed [（6.86± 2.75）RLU/mg protein vs （ 11.95 ± 6.60） RLU/mg protein], and the activity of NADPH oxidase also decreased [（8.38±3.76）RLU/mgproteinvs （14. 17＋3.88）RLU/mgprotein] （all P〈0. 05）. At follow up in 47 AMI pati

关 键 词：急性心肌梗死 左室重构 NADPH氧化酶 丙二醛 

分 类 号：R542.2[医药卫生—心血管疾病]