【摘要】 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。更多还原

【Abstract】 Objective:To study the changes and clinical significance of glutathione redox-state in patients with coronary artery disease (CAD). Methods:A total of 76 patients were divided into 3 groups, including 21 cases of acute myocardial infarcion (AMI), 30 cases of unstable angina pectoris (UAP), 25 cases of stable angina pectoris (SAP), and there were also 22 healthy people to be controls. The plasma concentrations of GSH and GSSG were determined by using glutathione reductase recycling method. Redox potential (EhGSH/GSSG) was calculated by using Nernst equation according to the concentration of reduced and oxidized glutathoine. ELISA was carried out for cTnI and CK-MB quantitative detection.Results:In CAD group, the concentration of GSH was significantly lower while that of GSSG was obviously higher than those in control group (P<0.01), and the differences in the concentrations of these 2 indexes and the value of EhGSH/GSSG were observed between AMI、UAP and SAP subgroups.Furthermore, the concentration of GSH was negatively (r=-0.572,r=-0.521, P<0.01)while GSSG was positively (r=0.485, r=0.440, P<0.01) correlated with cTnI and CK-MB, and the positive correlation was also found between EhGSH/GSSG and cTnI as well as CK-MB (r=0.606, r=0.612, P<0.01) in CAD patients.Conclusion:There is an imbalance in antioxidation and prooxidation in the development of CAD, and the plasma GSH and GSSG as well as the ratio of EhGSH/GSSG can be used as the marker for reflecting the severity of CAD.更多还原