冠心病患者脂质过氧化水平与HO-1活性变化及阿托伐他汀的干预效果研究

Changes of serum lipid peroxidation level and HO-1 activity in patients with coronary artery disease and treatment effect of atorvastatin

目的探讨冠心病患者体内脂质过氧化水平与HO-1活性变化及阿托伐他汀的干预效果。方法从接受冠脉造影者中选择冠脉正常者45例(A组)、稳定型心绞痛患者49例(B组)、非ST段抬高的急性冠脉综合征患者46例(C组),抽取肘静脉血检测血清OX-LDL、MDA浓度及HO-1活性,B、C组应用阿托伐他汀10mg/d治疗2个月后再复查上述指标。结果B组及C组血清OX-LDL、MDA浓度及HO-1活性均显著高于A组(P<0.05或P<0.01),相比之下,C组又明显高于B组(P<0.05或P<0.01)。直线相关分析显示,血清HO-1活性与OX-LDL及MDA均呈正相关关系(分别为r=0.445,P<0.05;r=0.419,P<0.05)。经阿托伐他汀治疗后,B组血清OX-LDL、HO-1及C组血清OX-LDL、MDA、HO-1均较治疗前显著降低(P<0.05或0.01)。结论冠心病患者体内氧化应激水平显著升高。阿托伐他汀能有效降低冠心病患者升高的氧化应激水平。HO-1是体内氧化应激状态的一个敏感预测指标。

[Objective] To explore the serum lipid peroxidation level and heme oxygenase-1 （HO-1） activity in patients with coronary artery disease （CAD） and the treatment effect of atorvastation. [Methods] 140 patients were all underwent coronary artery angiography and divided to group A （without atheroselerosis lesion, n =45）, group B （stable angina, n =49） and group C （non-ST- segment elevation acute coronary syndrome, n =46）. Their serum OX- LDL, MDA and HO-1 activity were measured ,and it were measured again in patients of group A and group B after treatment with atorvastatin 10mg daily for two mounths. [Results] The serum OX-LDL, MDA, HO-1 of group C and group B were all significant higher than that of group A （P 〈0.05 or P 〈0.01）. Furthermore, all the indices of groupC were still higher when compared with group B （P 〈0.05 or P 〈0.01）. By corrolation analysis, the serum HO-1 activity were positively correlated with OX-LDL （r =0.445, P 〈0.05） and MDA （r =0.419, P 〈0.05）. After treated with atorvastatin, the serum OX-LDL, HO-1 of group B and the serum OX-LDL, MDA and HO-1 of groupC were all significant lower than that before treatment （P 〈0.05 or P 〈0.01）. [Conclusion] The oxidative stress level elevated significantly in patients with CAD and could be suppressed effectively by atorvastatin. HO-1 should be a sensitive predictor of oxidative stress.