环氧二十碳三烯酸与冠心病心力衰竭相关性的初步研究

Clinical study of the relationship between epoxyeicosatrienoic acid and heart failure caused by coronary heart disease

目的 比较观察冠心病心力衰竭（HF）患者与健康体检者血清环氧二十碳三烯酸（EETs）水平，评价EETs水平与HF的相关性。方法80例病例包括HF组（60例）和正常对照组（20例）两组，根据患者病程及本次发病情况将HF组分为慢性心力衰竭组（CHF组）、慢性心力衰竭急性发作组（CHFAD组）和急性心力衰竭组（AHF组），每组20例。采血离心取血清应用高效液相色谱法测定EETs曲线下面积，并计算血清EETs水平。同时检测血压、心率、血细胞计数、空腹血糖、血脂及超声心动图等指标。结果①心率：CHFAD组、AHF组明显高于CHF组、正常对照组（P〈0．05）；②白细胞计数：AHF组明显高于CHF组、CHFAD组、正常对照组（P〈0．05）：③EETs水平：AHF组明显高于CHF组、CHFAD组（P〈0．05），CHF组明显低于正常对照组（P〈0．05）；④相关性：CHF组EETs水平与心率呈负相关（r=-0．661，P=0．019）。结论急性心力衰竭时血清EETs水平升高，应与EETs的心血管保护作用有关；慢性心力衰竭时EETs水平下降，可能与内源性EETs生成异常有关。

Objective To investigate the serum epoxyeicosatrienoic acid （ EETs） level in the patients with heart failure （ HF） and control group, and to evaluate the relationship between the level of EETs and HF. Methods 80 subjects were divided into two groups： HF group （ 60 subjects ） and control group （20 subjects ）. HF group was divided into three subgroups： chronic heart failure （CHF ） group,chronic heart failure acute destabilized （ CHFAD） group and acute heart failure （ AHF） group, and each group has 20 subjects. Peripheral blood samples were taken after the fasting by centrifugation. The superuatant was disposed and the area under curve of EETs were measured by HPLC, then we calcu- lated the EETs concentration. BP, heart rate, blood cell count, FBG,blood lipid and the parameters of UCG were also assessed. Results （i）There were significant differences in heart rate between control group,CHF group and CHFAD group, AHF group （ P 〈 0.05 ） respectively.②There were significant differences in white cell counts between control group, CHF group, CHFAD group and AHF group （ P 〈0. 05） respectively. ③There were also significant differences in EETs level between AHF group and CHF group, CHFAD group （P 〈 0. 05） respectively, between control group and CHF group （ P 〈0. 05 ）.④ EETs level had negative correlation with HR in CHF group（ r = -0. 661 ,P =0. 019 ）. Conclusion The levels of serum EETs increase in the patients with AHF, which indicate that EETs may have the protective effect on the heart. The levels of endogenous EETs decrease in the patients with CHF, which was concerned with the endogenetic disorder of EETs.