还原型谷胱甘肽对慢性肺源性心脏病急性加重期患者血中脂质过氧化物及抗氧化物酶活性的影响

Action of Reduced Glutathione on Plasma Lipid Peroxidation and Antioxidant Enzymes of Exacerbations of Chronic Cor Pulmonale

目的:探讨还原型谷胱甘肽对慢性肺源性心脏病急性加重期患者血中脂质过氧化物及抗氧化物酶活性的影响。方法:检测27例健康成年人静脉血全血超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和过氧化氢酶(CAT)的活性及血浆脂质过氧化物(LPO)和丙二醛(MDA)的浓度,与慢性肺心病急性加重期组治疗前的此5项指标进行对应比较;选择68例慢性肺源性心脏病急性加重期患者,随机分成两组,试验前均监测静脉血全血SOD、GSH-Px和CAT的活性及血浆LPO和MDA的浓度以及右室压(RVP)、平均肺动脉压(mPAP)等血流动力学指标并评价心功能。试验组在给予常规治疗的同时合并给予还原型谷胱甘肽1.2 g/d,稀释后静脉滴注,疗程2周;对照组只给予常规治疗。2周后,复测上述指标,比较各组治疗前后的变化。结果:(1)肺心病急性加重期组的全血SOD、GSH-Px和CAT的活性比对照组低,而血浆LPO及MDA的浓度比对照组高(均P<0.05)。(2)还原型谷胱甘肽组试验前后比较,全血SOD、GSH-Px和CAT活性明显增高,且血浆LPO和MDA浓度明显降低(均P<0.05);而对照组则无显著变化(P>0.05)。(3)还原型谷胱甘肽组试验前后比较,PVP、mPAP均明显下降(P<0.05);而对照组无显著变化(P>0.05)。(4)还原型谷胱甘肽组心力衰竭纠正的有效率显著高于对照组(P<0.05)。结论:慢性肺源性心脏病急性加重期患者机体的抗氧化能力降低,还原型谷胱甘肽可通过提高机体的抗氧化能力,消除氧自由基和脂质过氧化物起到降低肺动脉和右心室压力、纠正心力衰竭的作用。

Objective： To Explore the action of reduced glutathione on plasma lipid peroxidation and antioxidant Enzymes of exacerbations of chronic cor pulmonale. Methods：27 healthy adults were selected as health control group, concentration of LPO, MDA and activity of SOD, GSH-Px and CAT of venous blood were measured and compared with chronic cor pulmonale patients in acute attack stage before treated with reduced glutathione. 68 acute attack chronic cor pulmonale patients were randomly assigned into two groups, all the patients were detected the concentration of LPO, MDA and activity of SOD, GSH-Px, CAT of venous blood , the levels of right ventricle pressure, average pulmonary arterypressure and the cardiac function before the trial. In addition to the routine treatment, the reduced glutathione group patients were given reduced glutathione intravenous infusion （1.2 g/d）for 2 weeks, but the control group patients were only given routine treatment. 2 weeks later, the above parameters were measured again and compared the change of them. Results： （1） The activity of SOD, GSH-Px and CAT of acute attack chronic cor pulmonale patients group were lower than health adult group, but the quantity of LPO, MDA were higher than health adult group（ all P〈0.05 ）. （2） 2 weeks later, the markers of right ventricle pressure , average pulmonary artery pressure , the quantity of LPO and MDA in reduced glutathione group were decreased （P〈0. 05 ）, the activity of SOD, GSH-Px and CAT in reduced glutathione group were increased（ all P〈0.05 ） , but there were no change in control group （P〉0.05）. （3） heart failure redressing rate of reduced glutathione group were higher than control group （ all P〈0. 05 ）. Conclusion： The activity of antioxidation enzymes in acute attack chronic cor pulmonale patients＇ are decreased. Treatment with reduced glutathione can improve the activity of these enzymes, by decreasing the pressure of right ventricle and pulmonary artery and ameliorate the cardiac function.