慢性肾衰竭合并冠心病患者血浆氧化型低密度脂蛋白水平变化及临床意义

The plasma ox-LDL levels in patients with chronic renal failure and coronary heart disease

目的探讨慢性肾衰竭(CRF)合并冠心病患者血浆氧化型低密度脂蛋白(ox-LDL)水平变化及临床意义。方法用ELISA方法测定299例住院病人和111例健康自愿者血浆ox-LDL水平,同时测定血浆TC、TG、HDL-C、LDL-C、Scr与ALB指标。结果血浆ox-LDL水平:CRF合并冠心病组〔n=148,(430.88±190.56)μg/dl〕明显高于非合并冠心病组〔n=72,(139.13±50.15)μg/dl〕(P<0.05);CRF合并不稳定性心绞痛组〔n=66,(545.58±202.89)μg/dl〕明显高于合并稳定性心绞痛组〔n=82,(255.75±112.3)μg/dl〕(P<0.05)。CRF组〔n=220,(372.18±153.68)μg/dl〕明显高于正常对照组〔n=111,(34.90±17.65)μg/dl〕与慢性肾炎组〔n=79,(40.64±20.20)μg/dl〕(P<0.05);但慢性肾炎组与正常对照组无显著性差异(P>0.05)。结论CRF患者血浆ox-LDL水平显著高于正常人及慢性肾炎患者,并发冠心病的患者其血浆ox-LDL水平升高更为明显,其中合并不稳定性心绞痛患者血浆ox-LDL水平尤其高。因此,CRF患者血浆ox-LDL浓度的高低可间接提示动脉粥样硬化的存在及严重程度。

Objective To investigate the plasma levels of oxidized low density lipoprotein （ox-LDL） in patients with chronic renal failure（CRF） and coronary heart disease. Methods 299 patients and 111 healthy subjects were taken venous plasma after fasting for 12 h and vegetable diet for one day. The levels of ox-LDL were measured by sandwich ELISA. Results The plasma levels of ox-LDL were significantly elevated in CRF patients [ （ 372. 18 ± 135. 68 ） μg/dl , n = 220 ] compared with those of control subjects [ （ 34. 90 ± 17.65 ） μg,/dl , n = 111 ] and chronic glomerulonenephritis patients [ （40.64 ± 20. 20 ） μg/dl, n = 79 ] （ P 〈 0.05 ） . The levels of ox-LDL of CRF patients with coronary heart disease （CHD） [ n = 148, （430. 88 ± 190. 56） μg/dl] were more than those of CRF patients without CHD[ n = 72, （ 139. 13 ± 50. 15 ） μg/dl ] （ P 〈 0. 05 ）. And then, the levels of ox-LDL in CRF patients with unstable angina pectoris [ n = 82, （545.58 ± 202. 89） μg/dl] were significantly higher than those of CRF patients with stable angina pectoris [n =66, （255.75 ± 112. 38） μg/dl） （P 〈 0.05） ]. Conclusions The elevated level of plasma ox-LDL in CRF patients may result in artherosclerosis disease.