冠心病患者氧化应激水平和窦房结内游走性节律的相关性研究

Correlation between oxidative stress level and sinoatrial node migratory rhythm in patients with coronary heart disease

目的:探讨冠心病患者心肌氧化应激和窦房结内游走性节律的相关性。方法:选择2018年8月至2021年5月江门市中心医院诊治的冠心病患者98例作为冠心病组,同期选择无器质性心脏病心功能正常的体检人群98例作为对照组。所有研究对象给予心电图与超声心动图检查,并测定血清还原型谷胱甘肽(GSH)、氧化型谷胱甘肽(GSSG)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平,记录上述氧化应激指标水平、窦房结内游走性节律状况并进行相关性分析。结果:冠心病组的窦房结内游走性节律发生率为45.9%(45/98例),高于对照组的7.1%(7/98例),差异具有统计学意义( =37.797,P<0.05)。冠心病组血清GSSG、MDA水平高于对照组,血清SOD与GSH水平低于对照组(P<0.05)。冠心病组的左房内径(LA)、右房内径(RA)高于对照组,射血分数(EF)低于对照组(P<0.05)。在冠心病组中,窦房结内游走性节律与GSH、SOD呈负相关(r=-0.566、-0.672,P均<0.001),与MDA、GSSG呈正相关(r=0.614、0.714,P均<0.001)。结论:冠心病患者多伴随有氧化应激状态与窦房结内游走性节律,表现为血清SOD、GSH的低表达与GSSG、MDA的高表达,两者存在相关性。

Objective: To explore the correlation between oxidative stress level and sinoatrial node migratory rhythm in patients with coronary heart disease(CHD). Methods: Ninety-eight patients with coronary heart disease in Jiangmen Central Hospital from August 2018 to May 2021 were enrolled as the CHD group, and 98 physical examination people without organic heart disease and with normal cardiac function were enrolled as the control group. ECG and echocardiography were performed in all subjects, and the levels of serum reduced glutathione(GSH), oxidized glutathione(GSSG), malondialdehyde(MDA) and superoxide dismutase(SOD) were detected. The levels of these oxidative stress indexes and migratory rhythm in sinoatrial node were recorded and the correlation was analyzed. Results: The incidence rate of sinoatrial node migratory rhythm in CHD group was 45.9%(45/98 cases), which was higher than 7.1%(7/98 cases) in the control group( =37.797,P<0.05). The levels of serum GSSG and MDA in CHD group were higher than those in control group, and the levels of serum SOD and GSH were lower than those in control group(P<0.05). Left atrial diameter(LA) and right atrial diameter(RA) in CHD group were higher than those in control group, and ejection fraction(EF) was lower than that in control group(P<0.05).In CHD group, the sinoatrial node migratory rhythm was negatively correlated with GSH and SOD(r=-0.566,-0.672, P<0.001), and positively correlated with MDA and GSSG(r= 0.614, 0.714, P<0.001). Conclusion: Patients with CHD are mostly accompanied by oxidative stress and sinoatrial node migratory rhythm, which is manifested by low expression of SOD and GSH in serum and high expression of GSSG and MDA. There was a correlation between sinoatrial node migratory rhythm and serum SOD, GSSG, GSH and MDA.