【摘要】 目的探讨血清硫氧还蛋白还原酶(TrxR)在不同类型冠心病患者中的水平,分析其与炎性因子的关联,探讨其在冠心病病理过程中的作用及可能机制。方法选择2011年12月—2012年12月在九江学院附属医院心血管内科住院并经冠状动脉造影确诊为冠心病的患者115例,其中稳定型心绞痛(SAP)组37例、不稳定型心绞痛(UAP)组37例、急性心肌梗死(AMI)组41例,同期另选择40例体检健康者作为对照组。根据Gensini评分系统对冠状动脉病变血管狭窄程度进行定量分析;并分别采用酶联免疫吸附试验与乳胶免疫比浊法检测血清中TrxR、肿瘤坏死因子α(TNF-α)与超敏C反应蛋白(hs-CRP)水平。分别比较各组TrxR水平及其与炎性因子和Gensini评分的相关性。结果 4组血清TrxR、TNF-α、hs-CRP水平比较,差异均有统计学意义(P<0.05);其中与对照组比较,SAP组、UAP组和AMI组TrxR水平降低,TNF-α、hs-CRP水平升高(P<0.05);与SAP组比较,UAP组和AMI组TrxR水平降低,TNF-α、hs-CRP水平升高(P<0.05);与UAP组比较,AMI组TrxR水平降低,TNF-α、hs-CRP水平升高(P<0.05)。相关性分析结果显示,血清TrxR水平与TNF-α水平呈负相关(r=-0.919,P<0.001);血清TrxR水平与hs-CRP水平呈负相关(r=-0.885,P<0.001);血清TrxR水平与Gensini评分呈负相关(r=-0.812,P<0.001)。结论低水平的TrxR促进了冠心病的发生、发展,其机制可能是通过调节TNF-α和hs-CRP水平参与其中。更多还原

【Abstract】 Objective To investigate the serum levels of thioredoxin reductase( TrxR) in patients with different types of coronary heart disease,to study the correlation between TrxR and inflammatory cytokines,and to explore the role of TrxR on the course of coronary heart disease and its possible mechanism. Methods A total of 115 patients who were diagnosed with coronary heart disease by coronary angiography in Department of Cardiovascular Diseases in Affiliated Hosptial of Jiujiang University from December 2011 to December 2012, were selected as study subjects, the patients were divided to 3 groups:stable angina pectoris( SAP) group( n = 37),unstable angina pectoris( UAP) group( n = 37),and acute myocardial infarction( AMI) group( n = 41). 40 normal healthy people were included in control group. The severity of coronary atherosclerosis were determined by the the Gensini score. Gensini score system was used for quantitative analysis of the stenosis degree of coronary artery lesion vessels. The serum levels of TrxR,TNF- α and hs- CRP were tested by enzyme- linked immunosorbent assay and latex turbidimetric immunoassay. Serum levels of TrxR were compared among different groups,the correlation between TrxR and inflammatory cytokines,and correlation between TrxR and Gensini score for severity of coronary artery disease was analyzed respectively. Results There were significant differences in serum levels of TrxR,TNF- α and hs- CRP among the four groups of the patients( P < 0. 05). The serum level of TrxR in SAP group,UAP group and AMI group was significantly lower than that in control group,respectively( P < 0. 05); while serum levels of TNF- α and hs- CRP in SAP group,UAP group and AMI group were significantly higher than those in control group,respectively( P < 0. 05). The serum level of TrxR in UAP group and AMI group was significantly lower than that in SAP group,respectively( P < 0. 05); while serum levels of TNF- α and hs- CRP inUAP group and AMI group were significantly higher than those in SAP group,respectively( P < 0. 05). The serum level of TrxR in AMI group was significantly lower than that in UAP group( P < 0. 05); while serum levels of TNF- α and hs- CRP in AMI group were significantly higher than those in UAP group,respectively( P < 0. 05). The correlation analysis results showed that serum TrxR level was negatively correlated with the TNF- α level( r =- 0. 919,P < 0. 001),hs- CRP level( r =- 0. 885,P< 0. 001) and Gensini coronary artery score( r =- 0. 812,P < 0. 001),respectively. Conclusion Low level of TrxR may promote the occurrence and development of coronary heart disease,TrxR may be involved in the occurrence and development of atherosclerosis by adjusting levels of TNF- α and hs- CRP.更多还原