老年急性心肌梗死患者谷胱甘肽和辅酶Ⅱ氧化还原态的变化及意义  

作　　者：李静宇[1] 黄彦生[2] 

机构地区：[1]河南省人民医院急救中心,郑州450003 [2]河南省人民医院康馨心内科,郑州450003

出　　处：《中华老年医学杂志》2013年第8期830-832,共3页Chinese Journal of Geriatrics

基　　金：河南省医学科技攻关计划项目（200704028）

摘　　要：目的探讨老年急性心肌梗死患者及心绞痛患者、冠状动脉正常老年人谷胱甘肽和辅酶Ⅱ还原态的变化及意义。方法根据患者临床表现、心电图和心肌标志物，选择老年急性心肌梗死患者64例（急性心梗组），根据冠状动脉造影结果选择老年心绞痛患者68例（心绞痛组）和冠状动脉正常人（对照组）66例，取外周静脉血，测血浆还原型谷胱甘肽（GSH）与氧化型谷胱甘肽（GSSG），还原型辅酶1I（NADPH）与氧化型辅酶Ⅱ（NADP）水平。根据Nernst方程，计算GSH／GSSG，NADPH／NADP’的氧化还原电位。结果与对照组比，急性心肌梗死组和心绞痛组GSH显著升高（分别为4．04±0．77μmol／L，5．89±0．85μmol／L，7．55士0．93μmol／L；P〈0．05或0．01），GSSG显著降低（O．70±0．05μmol／L，0．61±0．04μmol／L，0．53±0．03μmol／L；P〈0．05或0．01），GSH／GSG比值显著升高（5．18±1．06，8．78±1．51，12．80±1．93；P〈0．05或0．01），谷胱甘肽氧化还原电位显著降低（-123．49±1．18mV，-126．21±1．01mV，-128．71±1．29mV；P〈0．05或0．01）。与对照组比，急性心肌梗死组NADPH显著升高（分别为5．72±0．44nmol／L，6．83±0．55nmol／L；P〈0．05），NADPH／NADP比值升高（分别为2．29±0．10，2．58±0．26；P〈0．05），辅酶II氧化还原电位显著降低（分别为-306．3±2．44mV，-312．1±2．53mV；P〈0．05）。结论血浆氧化还原态失衡、向氧化方向偏移与冠状动脉粥样斑块形成及斑块破裂血栓形成密切相关。Objective To explore the changes of glutathione and nicotinamide adenine dinucleotide phosphate levels and their significances among elderly patients with acute myocardial infarction,elderly patients with angina pectoris and elderly people with normal coronary artery.Methods Totally 64 elderly patients with acute myocardial infarction were selected according to the clinical manifestation,electrocardiogram and myocardial markers.68 elderly patients with angina pectoris and 66 subjects with normal coronary artery (control group) were enrolled according to the coronary artery radiography.Peripheral venous blood in all subjects were taken and plasma glutathione (reduced form GSH and oxidized form GSSG) and nicotinamide adenine dinucleotide phosphate (reduced form NADPH and oxidized form NADP+) were measured.The GSH/GSSG ratio and NADPH/NADP+ redox potentials were calculated according to Nernst equation.Results Compared with control group,GSH level in acute myocardial infarction group and angina pectoris group significantly increased(4.04 ± 0.77 μmol/L,5.89 ± 0.85 μmol/L,7.55 ± 0.93 μmol/L; P＜0.05 or 0.01),GSSG decreased(0.70±0.05 μmol/L,0.61±0.04 μmol/L,0.53±0.03 μmol/L;P＜0.05 or 0.01),GSH/GSSG ratio increased(5.18±1.06,9.76±1.67,12.80±1.93; P＜0.05 or 0.01).The GSH/GSSG redox potentials decreased(-123.49 ± 1.18 mV,-126.21 ± 1.01mV,-128.71 ±1.29 mV;P＜0.05 or 0.01).Compared with control group,NADPH in acute myocardial infarction group increased(5.72 ± 0.44 nmol/L,6.83± 0.55 nmol/L ; P＜0.05),NADPH/NADP ratio increased (2.29±0.10,2.58±0.26,P＜0.05),the NADPH/NADP+ redox potentials significantly decreased (-306.3±2.44 mV,-312.1±2.53 mV; P＜0.05).Conclusions The imbalance of plasma redox status migrating to oxidization may have close relationships with atheromatous plaque formation,plaque rupture and thrombosis.

关 键 词：心肌梗死 谷胱甘肽 辅酶Ⅱ 

分 类 号：R542.22[医药卫生—心血管疾病]