冠状动脉慢血流现象与血清脂质过氧化水平的关系

目的: 观察冠状动脉慢血流现象（CSF）患者血清脂质过氧化水平的变化，并探讨CSF的影响因素。方法: 采用TIMI帧计数（TFC）法作为测定CSF的指标，将入选病例分为两组:CSF组35例，正常对照组35例，均排除既往冠心病、心肌病及其他类型心脏病。采用生化法测定血清中超氧化物歧化酶（SOD），谷胱甘肽过氧化物酶（GSH-PX）,丙二醛（MDA），过氧化脂质（LPO）的含量。结果: CSF组的血清MDA、LPO明显高于对照组［MDA:（18.9±2.0）μmol/L vs.（10.5±1.3）μmol/L，P<0.01］，［LPO:（2.8±0.4）μmol/L vs.（1.9±0.2）μmol/L，P<0.01］；CSF组血清GSH-PX明显高于对照组［GSH-PX:（0.22±0.04）μmol/L vs.（0.20±0.03）μmol/L，P<0.05］。CSF组血清SOD明显低于对照组［SOD:（72±11）kU/L vs.（79±10）kU/L，P<0.01］。在校正体质量指数、总胆固醇、尿素氮等后CSH-PX、MDA、LPO是CSF的危险因素（分别OR=3.987、4.782、3.381；分别为P<0.05、P<0.01、P<0.01）。SOD则是其保护因素（OR=0.892，P<0.05）。结论: CSF患者血清SOD下降，MDA、LPO、GSH-PX上升，体内氧化应激增强。

Serum lipid peroxidation levels in patients with coronary slow flow

AIM: To observe the levels of serum lipid peroxidation in patients with coronary slow flow (CSF) and to study related factors. METHODS: Thirty-five patients with documented CSF defined according to TIMI frame count method (TFC) and 35 patients with normal coronary flow were enrolled. Levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), malonyldialdehyde (MDA) and lipid peroxidation (LPO) were determined by biochemistry and logistic regression analysis was performed. RESULTS: Baseline data showed that compared with control group, MDA and LPO significantly increased in CSF group ［MDA: (18.9±2.0) vs.(10.5±1.3) mol/L, P<0.01］, ［LPO: (2.8±0.4) vs.(1.9±0.2) mol/L, P<0.01］. Serum GSH-PX also increased in CSF group ［GSH-PX: (0.22±0.04) vs.(0.20±0.03) mol/L, P<0.05］, but SOD significantly decreased in CSF group ［SOD: (72±11) vs.(79±10) kU/L, P<0.01］. After calibration of body mass index, total cholesterol and blood urea nitrogen, analysis showed that CSF was positively correlated with GSH-PX, MDA and LPO (β=1.768, 1.565 and 1.204, respectively, P<0.05, P<0.01, P<0.01) but was negatively correlated with SOD (β=0.115, P<0.05). CONCLUSION: In CSF patients, serum SOD decreases, whereas MDA, LPO and GSH-PX increase. The increased peroxide products of MDA, LPO and GSH-PX enhance oxidative stress in the body, which may result in CSF.