血管内皮细胞损害在动脉硬化性闭塞症发病中的意义

The role of OX LDL induced endothelial injury in the pathogenesis of arteriosclerotic obliteration

目的 探讨脂质过氧化物（ＯＸＬＤＬ）致ＥＣ损害与动脉硬化性闭塞症（ＡＳＯ）发病的关系及循环内皮细胞（ＣＥＣ） 、ＯＸＬＤＬ检测的临床价值。方法 ＡＳＯ 患者２９ 例，间歇性跛行组１５ 例，静息痛组８例，坏疽组６ 例。分别测其ＣＥＣ、ＯＸＬＤＬ及ＡＢＩ值。结果 ＣＥＣ及ＯＸＬＤＬ值患者组显著高于正常对照（Ｐ＜ ０．０１），且与病情严重程度一致（坏疽组＞ 静息痛组＞ 间歇性跛行组），ＣＥＣ与ＯＸＬＤＬ呈显著正相关（ｒＯＸＬＤＬ＝０．９６３）。ＡＢＩ值患者组虽明显低于正常对照，但静息痛组与坏疽组差异无显著性（ Ｐ＞ ０．１）。结论 ＯＸＬＤＬ是导致ＥＣ损害引发ＡＳＯ的重要原因。ＣＥＣ、ＯＸＬＤＬ可作为ＡＳＯ早期诊断及临床病情轻重判别的较好参考指标，以弥补无创指标ＡＢＩ的不足。

Objective\ To investigate the role of endothelial injury induced by oxidized low density lipoprotein (OX LDL) in the pathogenesis of arteriosclerotic obliteration (ASO) in vivo. Methods\ Twenty nine cases of ASO were divided into three groups according to the severity: the intermittent claudation group (15 cases), the rest pain group (8 cases) and gangrene group (6 cases). CEC, OX LDL, MDA and Ankle Brachial index (ABI) were determined in the patients and normal controls (20 cases) respectively. Results\ CEC, OX LDL in the ASO patients were significantly higher than in normal control ( P <0.01) and the levels were significantly increased with the severity increased. There was a powerful positive correlation between OX LDL and CEC (rOX-LDL=0.93, P <0.001). Although the ABI in the rest pain group was significantly higher than that in the gangrene group, there was no significance ( P >0.1). Conclusion\ EC injury induced by OX LDL might play an important role in the pathogenesis of ASO in vivo, and CEC and OX LDL can be used as a good reference for judging the severity and early lesion of ASO.\;