对接受冠状动脉疾病血管成形术患者的过氧化氢血浆水平和稳定一氧化氮终产物进行前瞻性评估。

Prospective evaluation of hydroperoxide plasma levels and stable nitric oxide end products in patients subjected to angioplasty for coronary artery disease.

作者信息

Wykretowicz A, Dziarmaga M, Szczepanik A, Guzik P, Wysocki H

机构信息

Department of Cardiology-Intensive Therapy, University School of Medicine, 49 Przybyszewskiego, 60-355, Poznan, Poland.

出版信息

Int J Cardiol. 2003 Jun;89(2-3):173-8. doi: 10.1016/s0167-5273(02)00472-2.

DOI:10.1016/s0167-5273(02)00472-2

PMID:12767540

Abstract

BACKGROUND

Oxidative stress appears to be involved in several processes that contribute to atherogenesis and restenosis following vascular intervention.

METHODS

The aim of our study was to evaluate prospectively the plasma concentrations of a hydroperoxide (ROOH) and nitric oxide end product (NO(x)) in patients subjected to coronary angioplasty (PTCA) and routine control angiography 6 months after the initial procedure. We prospectively studied 48 consecutive patients (39 men, nine women, mean age 52 years) with stable angina who underwent successful elective angioplasty. A vascular segment was considered successfully treated when the residual luminal narrowing in the dilated segment immediately after angioplasty was <50%. Angiographic follow-up was obtained in all of the patients. Plasma samples were drawn at baseline (before angioplasty) and serially after angioplasty (1, 3 and 6 months afterwards). Hydroperoxides were determined by the FOX II assay (ferrous oxidation in xylenol orange, Pierce Rockford, IL). Nitrate was converted in the presence of NO3 reductase. The Griess reagent was used for the measurement of NO2.

RESULTS

The overall angiographic restenosis rate was 35%. There were no significant differences in clinical variables between the patients with or without restenosis. The baseline levels (0.8+/-0.09 vs. 0.6+/-0.2 micromol/l) as well as the concentrations of authentic lipid hydroperoxide in plasma after 1 month (0.7+/-0.09 vs. 1.0+/-0.2 micromol/l) and 6 months (0.8+/-0.1 vs. 1.0+/-0.2 micromol/l) were similar in both groups. Three months after the angioplasty a significant increase in the ROOH level was noticed in the patients with restenosis (0.9+/-0.1 vs. 1.4+/-0.2, P=0.04). Plasma levels of NO(x) were similar in both groups at baseline (23.6+/-2.1 vs. 22.7+/-2.6 micromol/l) and 1 month after procedure (24.4+/-2.2 vs. 23.4+/-3.3 micromol/l). However, in patients with restenosis significant decreases in stable NO end products were observed 3 and 6 months after PTCA (18.1+/-1.5 vs. 13.3+/-1.7, P=0.04; 14.2+/-1.0 vs. 8.7+/-1.3, P=0.02, respectively).

CONCLUSIONS

In patients with angiographic restenosis a significant increase in lipid peroxidation accompanied by a reduction in the stable end products of nitric oxide in plasma is observed several months after PTCA.

摘要

背景

氧化应激似乎参与了导致血管介入术后动脉粥样硬化形成和再狭窄的多个过程。

方法

我们研究的目的是前瞻性评估接受冠状动脉血管成形术（PTCA）并在初始手术后6个月进行常规对照血管造影的患者血浆中氢过氧化物（ROOH）和一氧化氮终产物（NO(x)）的浓度。我们前瞻性地研究了48例连续的稳定型心绞痛患者（39例男性，9例女性，平均年龄52岁），他们均成功接受了择期血管成形术。当血管成形术后扩张段的残余管腔狭窄<50%时，认为血管段得到成功治疗。所有患者均进行了血管造影随访。在基线（血管成形术前）以及血管成形术后连续（术后1、3和6个月）采集血浆样本。通过FOX II测定法（二甲苯酚橙中的亚铁氧化，Pierce Rockford，伊利诺伊州）测定氢过氧化物。在硝酸还原酶存在的情况下将硝酸盐转化。使用格里斯试剂测量NO2。

结果

总体血管造影再狭窄率为35%。有或无再狭窄的患者在临床变量上无显著差异。两组患者的基线水平（0.8±0.09对0.6±0.2微摩尔/升）以及术后1个月（0.7±0.09对1.0±0.2微摩尔/升）和6个月（0.8±0.1对1.0±0.2微摩尔/升）血浆中真实脂质氢过氧化物的浓度相似。血管成形术后3个月，再狭窄患者的ROOH水平显著升高（0.9±0.1对1.4±0.2，P = 0.04）。两组患者在基线时（23.6±2.1对22.7±2.6微摩尔/升）和术后1个月时（24.4±2.2对23.4±3.3微摩尔/升）血浆中NO(x)水平相似。然而，在再狭窄患者中，PTCA术后3个月和6个月观察到稳定的NO终产物显著降低（分别为18.1±1.5对13.3±1.7，P = 0.04；14.2±1.0对8.7±1.3，P = 0.02）。