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目的:研究冠心病患者血浆谷胱甘肽氧化还原状态的变化及临床意义。方法:选择76例冠心病患者,其中急性心肌梗死(AMI)21例,不稳定型心绞痛(UAP)30例,稳定型心绞痛(SAP)25例,以健康体检人员22例作对照组,应用酶循环法测定血浆还原型谷胱甘肽(GSH)、氧化型谷胱甘肽(GSSG)浓度,并行同位素检查心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)。结果:冠心病患者血浆GSH浓度均低于正常对照组(P<0·01),而GSSG浓度均较对照组显著升高(P<0·01),其中AMI组其GSH和GSSG与UAP和SAP相比较,差异有统计学意义(P<0·01),UAP和SAP之间差异亦有统计学意义(P<0·01)。同时冠心病患者血浆GSH浓度和cTnI及CK-MB呈负相关(r=-0·572,r=-0·521P<0·01),而血浆GSSG浓度则和cTnI及CK-MB呈正相关(r=0·485,r=0·440P<0·01),其EhGSH/GSSG亦和cTnI及CK-MB呈正相关,(r=0·606,r=0·612P<0·01)。结论:冠心病患者存在谷胱甘肽氧化还原状态的异常改变,联合监测GSH和GSSG浓度有助于判断冠心病的临床风险。
Objective: To study the changes of plasma glutathione redox status in patients with coronary heart disease and its clinical significance. Methods: Seventy-six patients with coronary heart disease were selected. Among them, 21 cases were acute myocardial infarction (AMI), 30 cases were unstable angina pectoris (UAP) and 25 cases were stable angina pectoris (SAP) Plasma concentrations of glutathione (GSH) and oxidized glutathione (GSSG) were measured by cyclic method. Cardiac troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) were examined by parallel isotope method. Results: Plasma GSH concentrations in patients with coronary heart disease were lower than those in the normal control group (P <0.01) and GSSG concentrations were significantly higher than those in the control group (P <0.01) SAP, the difference was statistically significant (P <0.01). The difference between UAP and SAP was also statistically significant (P <0.01). At the same time, plasma GSH concentration in patients with coronary heart disease was negatively correlated with cTnI and CK-MB (r = -0.572, r = -0.521P <0.01), while plasma GSSG concentration was positively correlated with cTnI and CK- There was a positive correlation between EhGSH / GSSG and cTnI and CK-MB (r = 0.606, r = 0. 612P <0.01). Conclusion: There is an abnormal change of glutathione redox status in patients with coronary heart disease. Combined monitoring of GSH and GSSG concentrations may be helpful in judging the clinical risk of coronary heart disease.