还原型谷胱甘肽对冠心病患者抗氧化应激的短期效果

The Short Term Effect of Glutathione on Anti-Oxidative Stress in Patients with Coronary Heart Disease

目的探讨一种强有力抗氧化剂,还原型谷胱甘肽(阿拓莫兰)对冠心病是否具有治疗作用及其可能机制。方法随机选取典型冠心病患者(不稳定型心绞痛患者)85例,男性45例,女性40例,以收入院日期单双号随机进入两组:治疗组:拜阿司匹林+β受体阻滞剂+血管紧张素转换酶抑制剂(ACEI)类+注射用还原型谷胱甘肽(240 mg,ivgtt,1次/d,14 d,n=44);对照组:拜阿司匹林+β受体阻滞剂+ACEI 类(n=41)。分别于治疗前、治疗后对两组患者进行临床指标的观察、心电图检查,抽血测定丙二醛(MDA)、超氧化物歧化酶(SOD)和一氧化氮(NO)水平。结果治疗组的临床症状改善积分明显高于对照组(2.0+0.5比对照组:1.5+0.5,P<0.01)。治疗后两组患者的心电图(ST 段)积分均显著下降(治疗组:1.8+3.8比治疗前:10.1+5.9;对照组:4.2+3.7比治疗前:9.8+5.9,P 均<0.01),与对照组比较,还原型谷胱甘肽能更进一步降低心电图(ST 段)积分(1.8+3.8比对照组:4.2+3.7,P<0.01)。治疗后两组患者的 MDA 明显下降[治疗组:(4.4±0.7)比治疗前:(5.1±0.8)mmol/L;对照组:(4,7+0.7)比治疗前:(5.2+0.3)mmol/L,P<0.01或<0.05],SOD 显著升高[治疗组:(82.3±12.5)比治疗前:(68.7±15.6)mmol/L;对照组:(73.5+15.9)比治疗前:(68.3+15.0)mmol/L,P<0.01或<0.05),与对照组比较,还原型谷胱甘肽治疗后,MDA 降低,SOD 升高,NO 水平升高,都较对照组明显改善。结论还原型谷胱甘肽能明显改善冠心病患者的临床症状和心电图积分,其作用机制可能与抗氧自由基和改善内皮功能有关。

Objective To study the therapeutical effect of glutathione（GL）, a powerful antioxidant on the symptoms and ECG in patients with coronary heart disease and its mechanisms. Methods Eighty-five subjects with coronary heart disease were recruited（45 male and 40 female）. The patients were randomized to receive GL （ 240 mg, ivgtt, qd, for 14 days, n = 44 ） on the top of conventional treatment（aspirin＋β-blocks＋ ACEI） or conventional treatement alone （control, n = 41 ）. The serum MDA, SOD, NO levels were determined. Electrocardiography（ ST stage,T wave） was examined. Results GL significantly improved clinical symptoms scores （2.0＋ 0. 5 vs control：1. 5＋0.5, P〈0.01）, as well as electrocardiogram （ST） scores （GL：1.8＋3.8 vs before：10.1＋5.9; control： 4.2＋3.7 vs before： 9.8＋5.9, respectively, P〈0.01） with markedly intergroups differences （1.8＋3.8 vs control： 4.2 ＋ 3.7 P 〈 0.01 ）. The improvement of clinical symptoms and ECG were coincident with pronouncedly decreases in MDA （GL： 4.4±0.7 vs before：5.1±0.8 mmol/L; control： 4.7±0.7 vs before：5.2±0.3 mmol/L, P〈0.01 or 0.05）, increases in SOD（GL： 82.3±12.5 vs before： 68.7±15.6 mmol/L; control： 73.5±15.9 vs before：68.3±15.0 mmol/L, P〈0.01 or 0.05）, as well as meaningful increased in NO （GL： 56.7±12.5 vs before： 52.2±16.6; control： 53.2＋15.7 vs before： 50.5＋12.6 mmol/L, P all〈0.01 ）. After GL treatment, all the MDA, SOD, NO levels were better than that in control group. Coneuision Glutathione significantly improve the clinical symptoms and ECG scores of patients with coronary heart disease, which was associated with decreases in free radical oxidation and improve endothelial function.