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目的研究硫化氢(H2S)及一氧化氮(NO)气体信号分子在冠心病患者中的变化及其与冠脉病变类型的关系,探讨其在冠心病发病中的病理生理意义。方法冠心病组40例,造影正常对照组17例,冠心病患者根据临床表现和辅助检查,分为稳定性心绞痛组、不稳定性心绞痛组、急性心肌梗死组;根据冠脉造影结果,再分为单支病变组、双支病变组、三支病变组。采用硫敏感法测定所有研究对象血浆H2S含量,并用Greiss法测定血浆NO含量,分析不同亚型冠心病患者和对照者血浆H2S、NO含量的差异及H2S、NO与不同冠脉病变类型的关系。结果冠心病患者血浆H2S、NO含量为(26.10±14.27)、(44.25±9.71)μmol/L,远低于冠脉造影正常对照组的(51.74±11.94)、(53.94±4.36)μmol/L,两组比较差异均有统计学意义(P<0.01);在冠心病各常见亚型中,不稳定性心绞痛患者和急性心肌梗死患者血浆H2S含量分别为(23.60±14.41)μmol/L、(19.98±7.52)μmol/L,明显低于稳定性心绞痛患者的(38.41±14.53)μmol/L;急性心肌梗死患者血浆NO含量为(39.71±6.03)μmol/L,明显低于稳定性心绞痛患者的(44.25±9.71)μmol/L(P<0.05)。冠脉双支和多支病变组血浆H2S含量分别为(16.91±7.98)、(18.39±7.78)μmol/L,差异无统计学意义(P>0.05),但均明显低于单支病变组的(33.04±15.01)μmol/L(P<0.05);不同支数病变冠心病患者血浆NO含量差异无统计学意义(P>0.05)。冠脉血管有闭塞组其血浆H2S、NO含量明显低于单纯狭窄组(P<0.05)。结论 H2S与NO的代谢异常可能参与了冠心病的发病过程,其中血浆H2S含量的高低与冠脉病变类型相关。
Objective To investigate the changes of hydrogen sulfide (H2S) and nitric oxide (NO) signaling molecules in patients with coronary heart disease and their relationship with the types of coronary lesions, and to explore their pathophysiological significance in the pathogenesis of coronary heart disease. Methods 40 cases of coronary heart disease group and 17 cases of contrast normal control group were divided into stable angina pectoris group, unstable angina pectoris group and acute myocardial infarction group according to the clinical manifestations and auxiliary examinations. According to the result of coronary angiography, A single lesion group, double-vessel lesion group, three lesion group. The contents of H2S in plasma were measured by sulfur sensitive method. The content of plasma NO was determined by Greiss method. The plasma concentrations of H2S and NO in patients with different subtype of coronary heart disease were compared with those in control subjects, and the relationship between H2S, NO and different types of coronary lesions. Results The levels of plasma H2S and NO in patients with coronary heart disease were (26.10 ± 14.27) and (44.25 ± 9.71) μmol / L, respectively, which were much lower than those of the control group (51.74 ± 11.94 and 53.94 ± 4.36 μmol / L, There were significant differences between the two groups (P <0.01). In all common subtypes of coronary heart disease, plasma H2S levels in patients with unstable angina and acute myocardial infarction were (23.60 ± 14.41) μmol / L and (19.98 ± 7.52) μmol / L, which was significantly lower than that of patients with stable angina (38.41 ± 14.53 μmol / L). The plasma NO level in patients with acute myocardial infarction was (39.71 ± 6.03) μmol / L which was significantly lower than that of patients with stable angina 44.25 ± 9.71) μmol / L (P <0.05). The plasma levels of H2S in patients with double-branch coronary artery and multi-vessel disease were (16.91 ± 7.98) and (18.39 ± 7.78) μmol / L respectively, with no significant difference (P> 0.05) (33.04 ± 15.01) μmol / L, respectively (P <0.05). There was no significant difference in plasma NO levels between patients with different branches and coronary lesions (P> 0.05). The levels of plasma H2S and NO in patients with coronary artery occlusion were significantly lower than those in patients with simple coronary artery stenosis (P <0.05). Conclusions The abnormal metabolism of H2S and NO may be involved in the pathogenesis of coronary heart disease. The content of H2S in plasma is correlated with the type of coronary artery disease.