急性病毒性心肌炎患者体内氧化应激反应及损伤

Oxidative stress and potential oxidative damage in the patients with acute coxsackie virus myocarditis

目的:探讨急性病毒性心肌炎(ACM)患者体内的氧化应激反应以及潜在的氧化损伤。方法:对57例ACM患者(病例组)和60例健康成人志愿者(HAV,对照组)的血浆一氧化氮(NO)、过氧化脂质(LPO)的含量和红细胞LPO的含量及血浆谷胱甘肽转移酶(GST)活性和红细胞过氧化氢酶(CAT)活性进行了检测,对2组各生化参数的含量、活性及95%可信区间进行了比较。对ACM患者血浆GST活性与其他生化参数进行直线相关分析,并对ACM患者机体潜在氧化损伤的相对危险度估计及其95%可信区间进行了分析。结果:(1)病例组血浆NO、LPO含量和红细胞LPO含量明显高于对照组,血浆GST活性和红细胞CAT活性明显低于对照组(P均<0.001);(2)病例组血浆NO、LPO含量和红细胞LPO含量平均值的95%可信区间的下限均高于对照组相应生化参数平均值95%可信区间的上限,而血浆GST活性和红细胞CAT活性平均值的95%可信区间的上限均低于对照组相应生化参数平均值95%可信区间的下限;(3)ACM患者随着GST活性的降低,血浆NO、LPO含量和红细胞LPO含量逐渐升高,呈直线负相关(P<0.05)。而红细胞CAT活性逐渐降低.呈直线正相关(P<0.01-0.001);(4)与对照组比较,ACM患者遭受潜在氧化损伤的相对危险度就95%可信区间来说,最小是对照组的1.319倍,最大是对照组的11.366倍。结论:ACM患者体内的NO代谢紊乱,自由基病理性连锁反应加剧,引起严重的氧化应激反应和潜在的氧化损伤。治疗ACM患者应每日补充适量的维生素C、E等抗氧化剂,以减缓患者体内潜在的氧化损伤。

Objective： To study oxidative stress in the patients with acute coxsackie virus myocarditis （ACM） and potential oxidative damage in their bodies. Methods： 57 ACM patients and 60 healthy adult volunteers （HAV） were enrolled in a random control design study. To determine the contents of nitric oxide （NO）, lipoperoxides （LPO） in plasma as well as content of LPO in erythrocytes,and measure the activity of glutathione-s-transferase（GST） in plasma and activities of catalase （CAT） in erythrocytes, the datas were compared between the two groups. 95% confidence limits of these data were compared between the two groups. To investigate the relationship between GST and other data of ACM patients. To evalue the relative risk ratio of potential oxidative damage in the ACM patients and analysis the relative risk ratio of 95% confidence interval. Results： Compared with the average values in the HAV group, the average values of NO in plasma, and LPO in plasma and LPO in erythrocytes in the ACM group were significantly increased （P 〈0. 001）, while the average values of GST in plasma as well as those of CAT in the ACM group were significantly decreased （P 〈0. 001）. The low limite of 95% confidence interval of NO in plasma, and LPO in plasma and LPO in erythrocytes in the ACM group were higher than the high limites of these data in the HAV group, while the high limites of 95% confidence interval of GST and CAT in the ACM group were lowerer than the low limites of these data in the HAV group, With decrease of GST activity in the ACM patients, the values of NO in plasma, and LPO in plasma and LPO in erythrocytes in the ACM patients were significantly increased and presented negative linear correlation （P 〈0. 05）, while CAT in the ACM patients were significantly decreased and presented positive linear correlation （P 〈0.01 -0. 001）. Compared with the HAV group, the relative risk ratio of 95% confidence interval of potential oxidative damage in the ACM patients was at the least increased by a factor of 1. 319, and was at the very most increased by a factor of 11. 366. Conclusions： The findings in this study suggested that the metabolism of NO in the ACM patients was disturbed,and pathological chain reaction of a series of free radicals was severely aggravated, thus induced enhancement of oxidative stress and potential oxidative damage in the ACM patients. It suggests that in the treatment of the ACM patients, the suitable doses of vitamin C, vitamin E and others should be given them in order to reduce potential oxidative damage and to speed their recovery.