Wang Guang, Mao Jie-Ming, Wang Xian, Zhang Fu-Chun
Institute of Vascular Medicine, Peking University Third Hospital, Beijing 100083, China.
Chin Med J (Engl). 2004 Nov;117(11):1650-4.
Cardiovascular diseases, especially coronary artery disease (CAD), are major causes of death in industrialized countries. Elevated concentrations of plasma homocysteine (Hcy) have been associated with an increased risk of CAD. Increased plasma levels of chemokine, characterized by their ability to induce migration and activation of leukocytes, may contribute to the pathogenesis of CAD. This study was designed to investigate the changes of plasma Hcy, monocyte chemoattractant protein-1 (MCP-1) and oxidative stress markers in acute coronary syndrome patients.
A total of 149 subjects were divided into four groups: 50 patients with unstable angina, 30 patients with acute myocardial infarction, 20 coronary restenosis patients after percutaneous coronary intervention and 49 healthy control subjects. Plasma levels of Hcy, MCP-1, malondialdehyde and superoxide dismutase were measured.
Plasma levels of Hcy and MCP-1 showed significant increases in unstable angina, acute myocardial infarction and restenosis patients compared with control subjects (P < 0.05, respectively). Plasma levels of malondialdehyde were significantly increased in unstable angina and acute myocardial infarction patients when compared with control subjects (P < 0.05, respectively). Plasma superoxide dismutase levels were significantly reduced in acute myocardial infarction patients when compared with control group (P < 0.01).
Hcy might act as an atherogenic factor through promoting chemokine, reactive oxygen species and oxidized low density lipoprotein production and thereby convert a stable plaque into an unstable potentially occlusive lesion.
心血管疾病，尤其是冠状动脉疾病（CAD），是工业化国家的主要死因。血浆同型半胱氨酸（Hcy）浓度升高与CAD风险增加相关。趋化因子血浆水平升高，其特征在于能够诱导白细胞迁移和活化，可能有助于CAD的发病机制。本研究旨在调查急性冠状动脉综合征患者血浆Hcy、单核细胞趋化蛋白-1（MCP-1）和氧化应激标志物的变化。
总共149名受试者分为四组：50名不稳定型心绞痛患者、30名急性心肌梗死患者、20名经皮冠状动脉介入术后冠状动脉再狭窄患者和49名健康对照者。测量血浆Hcy、MCP-1、丙二醛和超氧化物歧化酶水平。
与对照组相比，不稳定型心绞痛、急性心肌梗死和再狭窄患者的血浆Hcy和MCP-1水平显著升高（分别为P < 0.05）。与对照组相比，不稳定型心绞痛和急性心肌梗死患者的血浆丙二醛水平显著升高（分别为P < 0.05）。与对照组相比，急性心肌梗死患者的血浆超氧化物歧化酶水平显著降低（P < 0.01）。
Hcy可能通过促进趋化因子、活性氧和氧化型低密度脂蛋白的产生而作为致动脉粥样硬化因子，从而将稳定斑块转化为不稳定的潜在闭塞性病变。
