冠心病患者心指数和MAP与抗氧化系统活性和心血管不良事件的关系

The relationship between cardiac index and MAP and antioxidant system activity and cardiovascular adverse events in coronary heart disease patients

目的:探讨冠心病患者心指数和平均动脉压(mean arterial pressure,MAP)与抗氧化系统活性和心血管不良事件的关系。方法:随机选取诊治的冠心病患者105例,根据心指数分为<4.5 L/min/m^2(65例)和≥4.5 L/min/m^2(40例),另根据MAP值为65 mm Hg为分界点进行分组,检测两组抗氧化系统超氧化物歧化酶(Superoxide Dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GP)和过氧化氢酶(catalase,CAT)的水平,并分析其与不良事件发生率的相关性。结果:心指数<4.5 L/min/m^2组抗氧化指标SOD、GP和CAT均高于心指数≥4.5 L/min/m^2(P<0.05);MAP<65 mm Hg组患者上述抗氧化指标与MAP≥65 mm Hg比较差异无统计学意义(P>0.05);随访6个月发现,心指数≥4.5 L/min/m^2和MAP≥65 mm Hg组患者合并心血管不良事件包括再发心绞痛、再发心肌梗塞、恶性心律失常和心脏猝死,各组不良事件发生率比较差异有统计学意义(P<0.05)。结论:冠心病患者心指数越高,并发氧化应激反应越严重,同时增加了心血管不良事件发生率。

Objective： To study the relationship between cardiac index and mean arterial pressure（MAP）,and antioxidant system activity and cardiovascular adverse events in coronary heart disease（CHD） patients. Methods： 105 cases of CHD patients were randomly selected and,according to the cardiac index,divided into 4. 5 L/min/m^2 group（65 cases） and ≥ 4. 5 L/min/m^2（40 cases）. According to the boundary point,of which MAP was 65 mm Hg,the two groups were divided. The levels of superoxide dismutase（SOD）,glutathione peroxidase（GP） and catalase（CAT） were detected and their correlations with the incidence of adverse events were analyzed. Results： SOD,GP and CAT in the cardiac index 4.5 L/min/m^2 group were significantly higher than those in the ≥ 4.5 L/min/m^2 group（P〈0. 05）. There was no statistically significant difference of the above indexes between MAP 65 mm Hg group and MAP≥65 mm Hg group（P〈0. 05）. In the 6 months follow-up,there was significant difference of cardiovascular adverse events incidence including recurrence angina,myocardial infarction,malignant arrhythmia and sudden cardiac death cardiac in the cardiac index ≥4. 5 L/min/m^2 group and MAP≥65 mm Hg group（P〉0. 05）. Conclusion： The coronary artery disease patients with higher cardiac index will have more severe oxidative stress reaction,and the incidence of cardiovascular adverse events increases at the same time.