炎症、氧化应激与急性心肌梗死的关系及临床意义

Relationship and Cinical Significance of Inflammation and Oxidative Stress in Acute Myocardial Infarction

目的检测急性心肌梗死(AMI)患者血清8-异前列腺素F2a(8-iso-PGF2a)和超敏C-反应蛋白(hs-CRP)水平的变化,探讨炎症反应和氧化应激在AMI发生中的作用、相互关系及其与冠状动脉病变程度的关系。方法对50例AMI患者应用酶联免疫吸附法(ELISA)检测血清8-iso-PGF2a、免疫透射比浊法检测血清hs-CRP,同时进行冠状动脉造影检查,采用Gensini评分对冠状动脉病变程度进行量化。统计分析血清8-iso-PGF2a和hs-CRP的水平变化以及与冠状动脉病变程度的相关性。结果 AMI组患者血清8-iso-PGF2a和hs-CRP水平明显高于对照组,差异显著(t=4.84,4.93,P<0.01),且与冠状动脉Gensini评分呈正相关(r=0.56,0.39,P<0.05),血清hs-CRP和8-iso-PGF2a呈正相关(r=0.27,P<0.05)。结论 AMI的发生与发展是炎症反应和氧化应激两种因素相互作用的结果,联合检测血清8-iso-PGF2a和hs-CRP,对于更好地评估AMI患者体内的炎症和氧化应激状态、有效地进行抗炎和抗氧化治疗具有重要的指导意义。

Objective To detect the changes of serum 8-iso-prostaglandin F2a （ 8-iso-PGF2a ） andhigh sensitive C-reactive protein （ hs-CRP ） in acute myocardial infarction （ AMI ）, and explore the the relationship between oxidative stress, inflammatory reaction and severity of coronary artery disease. Methods The serum hs-CRP and 8-iso-PGF2a concentrations of 50 patients and control subjects were measured by enzyme-linked immunosorbent assay （ ELISA ） and immunotransmission turbidimetry respectively.Meanwhile, coronary angiography was carried out simultaneously and the Gensini score were employed to evaluate degree of coronary artery disease, and the results were statistically analyzed. Results Compared with the normal control group, the serum hs-CRP and 8-iso-PGF2a concentrations of in patient group were significantly higher （P 〈 0.05 ）, and were positively related with the Gensini score. The serum hs-CRP concentration also showed good positive relationship （ r=0.9034, P 〈 0.05 ） with 8-iso-PGF2a. Conclusion The interaction between oxidative stress and inflammation lead to the emergence and development of AMI, and then the combined determination of the serum hs-CRP and 8-iso-PGF2a concentrations can better evaluate oxidative stress and inflammation states in AMI patients and guide antioxidation and anti-inflammatory treatment.