血浆非对称二甲基精氨酸浓度与急性冠状动脉综合征的关系

Relationship between plasma asymmetric dimethylarginine's concentration and acute coronary syndrome

目的:探讨血浆非对称二甲基精氨酸(ADMA)浓度与急性冠状动脉综合征(ACS)及其不同亚组之间的相关性。方法:根据临床病情,并结合冠状动脉造影结果,将ACS组(88例)患者分为不稳定型心绞痛(UAP)亚组(56例)和急性心肌梗死(AMI)亚组(32例);对照组(42例)为冠状动脉正常患者。通过高效液相色谱联合质谱法(HPLC)测定血浆ADMA、L-精氨酸(L-Arg)含量,比色法测定HDL-C、TC、TG和尿酸(UA)。结果:ACS组血浆ADMA浓度显著高于对照组[(5.18±1.32)∶(3.70±1.32)μg/L,P<0.01],血浆L-Arg/ADMA浓度比低于对照组(1.64±0.60∶2.49±1.79,P<0.01),血浆L-Arg浓度在2组间差异无统计学意义。亚组间分析:AMI亚组血浆ADMA浓度显著高于对照组[(5.60±1.46)∶(3.70±1.32)μg/L,P<0.01]和UAP亚组[(5.60±1.46)∶(4.93±1.22)μg/L,P<0.05],血浆L-Arg/ADMA浓度比值低于对照组[(1.57±0.79)∶(2.49±1.79),P<0.01];UAP亚组血浆ADMA浓度高于对照组[(4.93±1.22)∶(3.70±1.32)μg/L,P<0.01],L-Arg/ADMA浓度比值低于对照组[(1.67±0.45)∶(2.49±1.79),P<0.01];血浆L-Arg浓度在3组间差异无统计学意义。血浆ADMA与HDL-C、TC、TG、UA浓度无相关性。结论:ACS患者血浆ADMA浓度显著升高,血浆L-Arg/ADMA浓度比值显著降低,ADMA浓度升高是ACS的危险因素,且独立于冠心病传统危险因子。

Objective：To observe the relationship of plasma asymmetric dimethylarginine （ADMA） concentration and acute coronary syndrome（ACS） as well as its subgroups in patients. Method：All the patients were received coronary artery angiography. ACS group（n = 88） was divided into unstable-angina （UA） sub group （77 = 56） and acute myocardium infraction （AMI） sub group（n= 32） according to angiographic figure and clinical data. The normal coronary patients provided as control group（n=42）. The plasma ADMA and L-Arginine （L-Arg） were measured by high performance liquid chromatography-mass spectrometry （HPLC）. HDL-C, TC, UA and TG were assayed by colorirnetry. Result：the concentration of plasma ADMA in ACS group was higher than in control group [（5.18±1.32） ： （3.70±1.32）μg/L,P〈0.01], whereas the ratio of L-Arg and ADMA was lower （1.64±0.60 ： 2.49±1.79, P〈0.01）. In sub-group analysis, the concentration of plasma ADMA in AMI group was higher than in control group[（5.60±1.46） ： （3.70±1.32）μg/L,P〈0. 01] or in uA group [（5.60± 1.46）： （4.93±1.22）μg/L,P〉0. 05],whereas the ratio of L-Argnine and ADMA concentration was lower [（1.57± 0.79） （1.67±0.45）,P〉0.05]; the concentration of plasma ADMA in UA group was higher than in control group[（4.93±1.22） ： （3.70±1.32）μg/L, P〈0.01], whereas the ratio of L-Argnine-and ADMA concentration was lower[ （ 1.67 ± 0.45 ） ： （ 2.49 ± 1.79 ）, P〈0.01 ] ; no differences were found with L-Arg concentration. There was no statistical relationship between ADMA and HDL-C, TC, TG, UA. Conclusion：The plasma ADMA con- centration increased when ACS occurred, while the ratio of L-Arg and ADMA decreased. High ADMA concentration may be an independent risk factor in ACS.