高级氧化蛋白产物在急性冠脉综合征患者的表达及其临床意义

Expression of advanced oxidized protein products in patients with acute coronary syndrome and the clinical significance thereof

目的探讨高级氧化蛋白产物(AOPP)在急性冠脉综合征患者的表达及其临床意义。方法急性冠脉综合征患者208例,其中不稳定心绞痛(UAP)患者78例,急性非ST段抬高心肌梗死(NSTEMI)患者62例,ST段抬高心肌梗死(STEMI)患者68例,以及年龄、性别相匹配的稳定性心绞痛(SAP)患者65例(对照组),接受冠脉造影证实冠心病诊断。采用分光光度计法测定所有患者的血清AOPP浓度,采用乳胶凝集反应法测定血清高敏C-反应蛋白(hs-CRP)浓度。单因素方差分析法比较各组血清AOPP和血清hs-CRP浓度的差异,血清AOPP浓度和血清hs-CRP浓度之间的关系作Spearman相关分析。结果ACS各组患者AOPP浓度和hs-CRP浓度显著高于SAP组(均P<0.05)。ACS组中急性心肌梗死患者AOPP浓度和CRP浓度显著高于不稳定心绞痛患者(均P<0.05),且急性ST段抬高心肌梗死患者AOPP浓度和CRP浓度显著高于急性非ST段抬高心肌梗死患者(均P<0.05)。血清AOPP浓度与血清CRP呈高度正相关(r=0.648,P<0.01)。结论AOPP参与了ACS的发病过程,并可能与炎症反应互相促进。AOPP浓度异常增高是反映ACS患者体内存在严重氧化应激状态的重要指标,对急性冠脉综合征患者的诊断和临床病情评估有重要的参考意义。

Objective To investigate the expression of advanced oxidized protein products （AOPP） in patients with acute coronary syndrome （ACS） and the clinical significance thereof. Methods Peripheral blood samples were collected from 208 ACS patients, including 78 patients with unstable angina pectoris （USAP）, 62 with acute non-ST-segment-elevation myocardial infarction （NSTEMI）, and 68 with acute ST-segment elevation myocardial infarction （STEMI）, and 65 sex-, and age-matched patients with stable angina pectoris （SAP）. Spectrophotometry was used to detect the serum AOPP levels and latex agglutination test was used to detect the serum high sensitivity C-reactive protein （hs-CRP）. Spearmen method was used to analyze the correlation between the serum AOPP and CRP. Results The AOPP and hs-CRP levels of the patients with different t）,pe of ACS were all significantly higher than those of the SAP group （all P〈0.05）. The AOPP and hs-CRP levels of the acute myocardial infarction patients, especially of the STEMI patients, were significantly higher than those of the USAP patients （all P〈0.05）. The serum AOPP level was significantly positively correlated with the CRP level （r=0.648, P〈0.01 ）. Conclusion AOPP plays an important role in the pathophysiology of ACS. The serum AOPP level may be taken as a diagnostic indicator in clinical evaluation of acute coronary syndrome.