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目的:探讨氧化应激在围生期心肌病(PPCM)发病中的作用。方法:对35例PPCM患者和70例正常分娩产妇(对照组)检测血浆丙二醛(MDA)水平和谷胱甘肽过氧化酶(GSH-Px)活性,并测定N末端B型利钠肽(NT-pro BNP)及超声心动图等。结果:PPCM患者左室舒张末内径明显大于对照组〔(56.6±5.4)mm vs(48.4±4.5)mm,P<0.01〕,而左室射血分数明显低于对照组〔(36.6±6.7)%vs(65.2±9.5)%,P<0.01〕。PPCM患者血浆MDA明显高于对照组〔(13.2±2.1)mmol/L vs(7.9±1.6)mmol/L,P<0.01〕,GSH-Px活性明显低于对照组〔(92.6±28.1)×103U/L vs(186.5±31.6)×103U/L,P<0.01〕,相关分析显示,MDA和NT-pro BNP呈明显正相关关系(r=0.64,P<0.01)。结论:氧化应激在PPCM发病中起了重要的作用。
Objective: To investigate the role of oxidative stress in the pathogenesis of perinatal cardiomyopathy (PPCM). Methods: Plasma levels of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) were measured in 35 PPCM patients and 70 normal pregnant women (control group). The levels of N-terminal B-type natriuretic peptide (NT-pro BNP) and echocardiography. Results: The left ventricular end-diastolic diameter of patients with PPCM was significantly higher than that of the control group (56.6 ± 5.4 mm vs 48.4 ± 4.5 mm, P <0.01), while the left ventricular ejection fraction was significantly lower than that of the control group (36.6 ± 6.7) % vs (65.2 ± 9.5)%, P <0.01〕. The plasma MDA in patients with PPCM was significantly higher than that in the control group [(13.2 ± 2.1) mmol / L vs (7.9 ± 1.6) mmol / L, P <0.01〕, GSH-Px activity was significantly lower than that in the control group [(92.6 ± 28.1) × 103U / L vs (186.5 ± 31.6) × 103U / L, P <0.01). Correlation analysis showed that there was a positive correlation between MDA and NT-pro BNP (r = 0.64, P <0.01). Conclusion: Oxidative stress plays an important role in the pathogenesis of PPCM.