冠心病患者氧化还原态状态及瑞舒伐他汀对患者氧化还原状态的影响研究

Study of oxidation-reduction state of the patients with coronary heart disease and the effects of rosuvastatin on the oxidation-reduction state of patients

目的探讨冠心病患者氧化还原态状态及瑞舒伐他汀对患者氧化还原状态的影响。方法选择2015年12月至2017年3月河南省人民医院心内科收治的冠心病患者496例为冠心病组,选择同期接受冠状动脉造影检查结果正常者498例为对照组,按照随机数表法将冠心病组患者分为两组,各248例,分别在常规治疗基础上接受瑞舒伐他汀和依折麦布治疗12周。测定对照组受试者及冠心病组患者治疗前后血浆还原型烟酰胺腺嘌呤二核苷酸磷酸(NADPH)与氧化型烟酰胺腺嘌呤二核苷酸磷酸(NADP+)水平,并根据Nernst方程计算NADPH/NADP+的氧化还原电位。结果冠心病组患者血浆NADPH水平低于对照组,NDPN+水平高于对照组,NADPH/NADP+氧化还原电位高于对照组,差异均有统计学意义(P<0.05),且患者氧化还原状态向氧化方向偏移。治疗12周后,瑞舒伐他汀组NADPH高于治疗前,NADP+低于治疗前,NADPH/NADP+氧化还原电位低于治疗前,差异有统计学意意义(P<0.05),且患者氧化还原状态向还原方向偏移;依折麦布组患者治疗后3项指标与治疗前相比,差异无统计学意义(P>0.05)。结论冠心病患者NADPH/NADP+氧化还原电位高,且氧化还原状态向氧化方向偏移,瑞舒伐他汀能够纠正冠心病患者的电位失衡状态。

Objective To investigate the oxidation -reduction state of the patients with coronary heart disease and the effects of treatment with rosuvastatin on the oxidation - reduction state of patients. Methods Four hundred and ninety - six patients with coronary heart disease who were treated in Henan Provincial People＇ s Hospital as CHD group and and 496 normal controls from December of 2015 to May of 2017 were enrolled in this study. All patients in CHD group were randomly divided into two groups, 248 eases in each group, and patients in these two groups were treated with rosuvastatin and ezetimibe for 12 weeks re- spectively. The levels of nicotinamide adenine dinucleotide phosphate reduced form（NADPH） and nicotinamide adenine dinucle- otide phosphate oxidized form（ NADP ~ ） of all the subjects were tested, and the two indicators of CHD patients were tested before and after treatment. The redox - potential of NADPH/NADP＋ was calculated based on the Nernst equations. Results Compared with control group, the level of NADPH was significantly lower, the level of NADP＋ and the redox - potential of NADPH/ NADP ＋ were significantly higher in CHD group（ P 〈 0. 05 ） , and the standard potential of patients was shifted in the oxidation di- rection. Rosuvastatin could evidently enhance the level of NADPH, lower the level of NADP ＋ and the redox - potential of NAD- PH/NADP＋ after 12 weeks of treatment（ P 〈 0.05 ）, and the standard potential of patients was shifted in the reduction direction. However, the levels of the three indicators in ezetimibe group was unchanged after treatment （P 〉 O. 05 ）. Conclusion The red- ox - potential of NADPH/NADP＋ of CHD patients was high. The standard potential of CHD patients was shifted in the oxidation direction, and the imbalance of potential could be corrected by rosuvastatin.