不对称二甲基精氨酸在冠心病临床分型中的应用(英文)

Correlation between plasma asymmetric dimethylarginine and different types of coronary heart disease

目的:测定冠心病患者中稳定型心绞痛和急性冠脉综合征的血浆不对称二甲基精氨酸( ADMA)、一氧化氮( NO)和血管性血友病因子( vWF)水平,探讨其与冠心病各临床类型之间的关系。方法:按纳入与排除标准入选了143例研究对象,其中包括非冠心病组64例,急性冠脉综合征组54例和稳定性心绞痛组25例。检测各组血浆ADMA,NO和vWF水平,并分析它们与急性冠脉综合征和稳定性心绞痛之间的相关性。结果:与非冠心病组和稳定型心绞痛组比较,急性冠脉综合征血浆ADMA水平显著升高(P<0.05)。与非冠心病组相比,稳定型心绞痛组血浆ADMA水平有升高趋势但差异无统计学意义(P>0.05) ;与非冠心病组相比,稳定型心绞痛和急性冠脉综合征组血浆NO水平均显著下降(P<0.05) ,急性冠脉综合征组下降的程度明显大于稳定型心绞痛组(P<0.05 ) ;与非冠心病组相比,稳定型心绞痛组和急性冠脉综合征组血浆vWF水平均显著升高(P<0.05 )。稳定型心绞痛组和急性冠脉综合征组之间血浆vWF水平差异无统计学意义(P>0.05 )。结论:血浆ADMA水平变化与冠心病中急性冠脉综合征的发生发展密切相关,血浆ADMA水平的变化可能是急性冠脉综合征的预测因子。

Objective To monitor the changes of plasma asymmetric dimethylarginine （ADMA）,nitric oxide （NO）,and von Willebrand factor （vWF） levels in patients with stable angina pectoris （SAP） or acute coronary syndrome （ACS） and to evaluate the correlation between ADMA and different types of coronary heart disease.Methods A total of 143 subjects were divided into a non-CHD group,a SAP group and an ACS group.Plasma levels of ADMA,NO and vWF were examined and their correlation with SAP or ACS was analyzed.Results Compared with the non-CHO or the SAP group,ADMA level was elevated in the ACS group （P〈0.05）.The ADMA level tended to increase in the SAP group compared with the non-CHD group,but had no significant difference （P〉0.05）.Compared with the non-CHD group,NO level was decreased in both the SAP and ACS group （P〈0.05）,and it decreased more in ACS group than that in the SAP group （P〈0.05）;vWF levels were increased in both the SAP and ACS group compared with the non-CHD group （P〈0.05）.There was no significant difference in the plasma levels of vWF in the SAP and the ACS group （P〉0.05）.Conclusion The change of plasma ADMA level is closely correlated with acute coronary syndrome.ADMA might be a clinical marker for acute coronary syndrome.