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目的:探讨髓过氧化物酶(MPO)与冠心病(CHD)的关系,预测CHD发生的危险度。方法:采用病例-对照研究方法。选择住院CHD患者219例,其中稳定型心绞痛(SAP)组74例,不稳定型心绞痛(UAP)组97例,急性心肌梗死(AMI)组48例;对照组70例,根据临床症状、心肌标志物等理化指标检查及冠状动脉造影结果确诊。用酶联免疫测定法检测各组血浆MPO的含量。用聚合酶链-限制性片段长度多态性(PCR-RFLP)和基因测序法判定各研究对象的基因型。结果:急性冠状动脉综合征(ACS)组MPO浓度明显高于SAP组和对照组(P<0.01),SAP组与对照组之间差异无统计学意义(P>0.05);MPO在单支、双支、3支病变组中均高于对照组(P<0.05);MPO在1-20分、21-40分、大于40分组中均高于对照组(P<0.05);携带GA型基因的CHD的发病率是携带AA型基因的3.10倍;携带型GG基因的CHD发病率是携带AA型基因的2.70倍。结论:MPO冠状动脉粥样硬化斑块不稳定的标志,与CHD的发生有关。MPO-463G/A多态性与CHD的易患性显著相关。
Objective: To investigate the relationship between myeloperoxidase (MPO) and coronary heart disease (CHD) and to predict the risk of CHD. Methods: A case-control study was conducted. A total of 219 CHD patients were enrolled, including 74 patients with stable angina pectoris (SAP), 97 patients with unstable angina pectoris (UAP), 48 patients with acute myocardial infarction (AMI) and 70 controls. According to clinical symptoms, Physical and chemical indicators such as physical examination and coronary angiography confirmed. The content of MPO in each group was detected by enzyme-linked immunosorbent assay. The genotype of each study was determined by polymerase chain-restriction fragment length polymorphism (PCR-RFLP) and gene sequencing. Results: The MPO concentration in acute coronary syndrome (ACS) group was significantly higher than that in SAP group and control group (P <0.01), but there was no significant difference between SAP group and control group (P> 0.05) (P <0.05); MPO was higher in the 1-20, 21-40, more than 40 groups compared with the control group (P <0.05) The incidence of CHD is 3.10 times that of the AA type gene. The incidence of CHD of the carrier GG gene is 2.70 times that of the AA type gene. Conclusions: The marker of unstable coronary atherosclerotic plaque in MPO is related to the occurrence of CHD. The MPO-463G / A polymorphism is significantly associated with CHD susceptibility.