维生素E补充剂对冠状动脉血管成形术前和术后循环细胞黏附分子的影响。

Ferns G A, Forster L A, Williams J C, Tull S P, Verma P K, Starkey B, Gershlick A H

Department of Clinical Biochemistry, The Royal Surrey County Hospital, Guildford, UK.

Ann Clin Biochem. 2000 Sep;37 ( Pt 5):649-54. doi: 10.1258/0004563001899924.

The soluble adhesion molecules P-selectin (sP-selectin) and intercellular adhesion molecule-1 (sICAM-1) are derived from platelets and endothelial cells. Circulating concentrations of these soluble adhesion molecules are raised in patients with atherosclerosis and following percutaneous transluminal coronary angioplasty (PTCA). We have investigated the effects of vitamin E supplements (800 IU/day) on circulating plasma ICAM-1 and P-selectin levels pre- and post-PTCA. Patients, randomized to group, were pre-treated with vitamin E or placebo (soybean oil) for 1 month before routine PTCA. Plasma sICAM-1 and sP-selectin were measured by enzyme-linked immunosorbent assay on blood taken immediately pre- and post-PTCA. Total protein and alpha-tocopherol were measured on the same samples. Plasma alpha-tocopherol concentrations increased in patients receiving vitamin E: 19.1 (1.5) [mean (standard error of the mean, SEM)] mg/mL post-PTCA versus 13.9 (0.6) mg/mL pre-PTCA (n=23; P<0.01). Plasma sP-selectin and sICAM-1 levels were not significantly increased following PTCA in the vitamin E group. Pre-angioplasty mean (SEM) plasma sP-selectin concentration in the vitamin E group was 8.83 (0.97) ng/mg protein; the corresponding mean post-angioplasty value was 9.34 (0.89) ng/mg protein (P=0.85). The mean (SEM) pre-angioplasty sICAM-1 concentration in this group was 2.18 (0.24) ng/mg protein, and was 2.20 (0.23) ng/mg protein following angioplasty (P = 0.84). In the placebo group (n = 24) there was a significant increase in mean (SEM) sP-selectin concentration following angioplasty, from 7.48 (0.73) to 9.70 (0.78) ng/mg protein (P<0.05). The change (mean, SEM) in plasma sP-selectin concentration following angioplasty was significantly greater for the placebo group [2.22 (0.50) ng/mg protein] than for the group receiving vitamin E [0.50 (0.50) ng/mg protein] (P<0.02). This difference remained significant (P<0.05) even after adjustment for pre-angioplasty P-selectin concentrations. Mean (SEM) plasma sICAM-1 concentrations remained unchanged following angioplasty [pre-angioplasty: 2.16 (0.20) ng/mg protein; post-angioplasty: 1.97 (0.13) ng/mg protein]. Vitamin E may therefore limit platelet or endothelial activation during PTCA.

可溶性黏附分子P-选择素（sP-选择素）和细胞间黏附分子-1（sICAM-1）来源于血小板和内皮细胞。动脉粥样硬化患者以及经皮腔内冠状动脉成形术（PTCA）后，这些可溶性黏附分子的循环浓度会升高。我们研究了维生素E补充剂（800 IU/天）对PTCA前后循环血浆中ICAM-1和P-选择素水平的影响。将患者随机分组，在常规PTCA前1个月用维生素E或安慰剂（大豆油）进行预处理。通过酶联免疫吸附测定法检测PTCA前后即刻采集的血液中的血浆sICAM-1和sP-选择素。在相同样本上测量总蛋白和α-生育酚。接受维生素E的患者血浆α-生育酚浓度升高：PTCA后为19.1（1.5）[均值（均值标准误，SEM）]mg/mL，而PTCA前为13.9（0.6）mg/mL（n = 23；P<0.01）。维生素E组PTCA后血浆sP-选择素和sICAM-1水平没有显著升高。维生素E组血管成形术前血浆sP-选择素浓度均值（SEM）为8.83（0.97）ng/mg蛋白；血管成形术后相应的均值为9.34（0.89）ng/mg蛋白（P = 0.85）。该组血管成形术前sICAM-1浓度均值（SEM）为2.18（0.24）ng/mg蛋白，血管成形术后为2.20（0.23）ng/mg蛋白（P = 0.84）。在安慰剂组（n = 24）中，血管成形术后血浆sP-选择素浓度均值（SEM）有显著升高，从7.48（图0.73）ng/mg蛋白升至9.70（0.78）ng/mg蛋白（P<0.05）。血管成形术后安慰剂组血浆sP-选择素浓度的变化（均值，SEM）[2.22（0.50）ng/mg蛋白]显著大于接受维生素E组[0.50（0.50）ng/mg蛋白]（P<0.02）。即使在对血管成形术前P-选择素浓度进行校正后，这种差异仍然显著（P<0.05）。血管成形术后血浆sICAM-1浓度均值（SEM）保持不变[血管成形术前：2.16（0.20）ng/mg蛋白；血管成形术后：1.97（0.13）ng/mg蛋白]。因此，维生素E可能会在PTCA期间限制血小板或内皮细胞的激活。