冠心病患者血浆谷胱甘肽水平变化的临床分析

目的 研究冠心病(CHD)患者血浆氧化还原态抗氧化系统的改变及临床意义.方法 对根据有无致动脉粥样硬化危险因素及冠状动脉造影结果筛选出的60例冠脉造影异常患者(CHD组)、28例有不同程度的动脉粥样硬化危险因素但冠脉造影正常患者(危险组)及30例正常患者(对照组)测定血浆还原型谷胱甘肽(GSH)和氧化型谷胱甘肽(GSSG)浓度,并根据Nernst方程计算出氧化还原电位(EhGSH/GSSG).其中CHD组又分为不稳定型心绞痛(UAP)组32例和急性心肌梗死(AMI)组28例.结果 GSH浓度CHD组与对照组比较差异有统计学意义(P＜0.05).GSSG浓度和EhGSH/GSSG值CHD组及危险组与对照组比较差异均有统计学意义(P＜0.05).UAP组与AMI组之间各指标差异均无统计学意义(P＞0.05).结论 动脉粥样硬化时机体的抗氧化作用减弱,存在氧化应激,提示改善机体的氧化还原状态有可能减慢或阻止动脉粥样硬化的发生与发展.

Clinical analysis of Level of glutathione redox-state in patients with acute coronary syndrome

Objective To study the changes and clinical significance of glutathione redox-state in patients with coronary heart disease (CHD). Methods Based on both with or without atherogenic risk factors and the result of coronary arteriography, 118 patients were calssified into three groups: control group( n =30) ,risk group(n =28) and CHD group (n =60). Venous blood sample was obtained, then the plasma reduced glutathione ( GSH) and oxidized glutathione (GSSC) were measured by using glutathione reductase recycling method. Redox potential(EhCSH/GSSG) was calculated using Nernst equation. According to clinical situation,CHD group was divided into two subgroups:un-stable angina pectoris( UAP) group(n = 32) and acute myocardial infarction (AMI) group (n =28). Results From control group to risk group,then to CHD group,GSH gradually decreased,and there was significant difference between CHD group and control group (P < 0.05 ) , but GSSG and EhGSH/GSSG gradually increased, there was significant difference between CHD group and risk group and control group (P < 0. 05). There was no significant difference be-tween the UAP subgroup and AMI subgroup in GSH,GSSG and EhGSH/GSSG(P >0.05). Conclusions Body's an-tioxidant capacity decreases and the oxidative stress exists in artherosclerosis, and furthermore there is a certain degree of relevance between oxidative stress and hyperlipoidemia,all these show that improving this situation may decelerate or prevent the formation and progress of artherosclerosis.