[冠状动脉成形术治疗急性心肌梗死和稳定型心绞痛患者血清丙二醛修饰低密度脂蛋白的变化]

[Changes in serum malondialdehyde-modified low-density lipoprotein in patients with acute myocardial infarction and stable angina pectoris treated by coronary angioplasty].

作者信息

Araki T, Kanaya H, Shimizu M, Mabuchi H, Kitayama M, Kanemitsu S, Takekoshi N

机构信息

Department of Internal Medicine, Saiseikai Kanazawa Hospital, Akatsuchi-machi Ni 13-6, Kanazawa, Ishikawa 920-0353.

出版信息

J Cardiol. 2001 Aug;38(2):55-60.

PMID:11525110

Abstract

OBJECTIVES

Serum malondialdehyde-modified low-density lipoprotein(MDA-LDL) was measured as a marker of oxidative stress, and the changes in serum MDA-LDL compared in patients with acute myocardial infarction and stable angina pectoris treated by percutaneous transluminal coronary angioplasty (PTCA).

METHODS

Forty-one patients with acute myocardial infarction or stable angina pectoris were admitted to our hospitals between January 2000 and June 2000. Direct PTCA was performed in 17 patients(MI group) and elective PTCA in 24 patients(AP group). Coronary angiography was performed in nine control subjects(control group). Serum MDA-LDL was measured in the peripheral venous blood before and immediately after procedures in each group(normal range 20-80 U/l).

RESULTS

There were no significant differences in patient characteristics, except age, between the MI group and AP group. Serum MDA-LDL was elevated above the normal range before the procedure in both groups(MI group 104.7 +/- 52.0 U/l, AP group 99.7 +/- 42.8 U/l), and significantly decreased immediately after the procedure(MI group 61.3 +/- 25.6 U/l, AP group 62.0 +/- 29.6 U/l), but there were no significant differences between the two groups. Serum MDA-LDL was elevated before the procedure (99.3 +/- 48.9 U/l) in the control group and significantly decreased immediately after the procedure(61.7 +/- 26.2 U/l). However, these values did not differ from the values before and immediately after the procedure in the MI group and the AP group. The percentage changes in serum MDA-LDL before and immediately after the procedure were -38 +/- 16% in the MI group, -37 +/- 17% in the AP group and -36 +/- 20% in the control group, and there were no significant differences between the three groups.

CONCLUSIONS

No significant difference in the changes in serum MDA-LDL was observed between patients with acute myocardial infarction and stable angina pectoris treated by PTCA. However, anticoagulants may affect the MDA-LDL measurements directly, because similar changes in serum MDA-LDL were observed in control subjects after only coronary angiography.

摘要

目的

测定血清丙二醛修饰低密度脂蛋白（MDA-LDL）作为氧化应激的标志物，并比较经皮腔内冠状动脉血管成形术（PTCA）治疗的急性心肌梗死患者和稳定型心绞痛患者血清MDA-LDL的变化。

方法

2000年1月至2000年6月期间，41例急性心肌梗死或稳定型心绞痛患者入住我院。17例患者（心肌梗死组）接受直接PTCA，24例患者（心绞痛组）接受择期PTCA。9例对照受试者（对照组）进行冠状动脉造影。在每组手术前和手术后立即在外周静脉血中测量血清MDA-LDL（正常范围20-80 U/l）。

结果

心肌梗死组和心绞痛组患者特征（年龄除外）无显著差异。两组手术前血清MDA-LDL均高于正常范围（心肌梗死组104.7±52.0 U/l，心绞痛组99.7±42.8 U/l），手术后立即显著降低（心肌梗死组61.3±25.6 U/l，心绞痛组62.0±29.6 U/l），但两组间无显著差异。对照组手术前血清MDA-LDL升高（99.3±48.9 U/l），手术后立即显著降低（61.7±26.2 U/l）。然而，这些值与心肌梗死组和心绞痛组手术前和手术后立即的值无差异。心肌梗死组、心绞痛组和对照组手术前和手术后立即血清MDA-LDL的百分比变化分别为-38±16%、-37±17%和-36±20%，三组间无显著差异。