Simm A, Wagner J, Gursinsky T, Nass N, Friedrich I, Schinzel R, Czeslik E, Silber R E, Scheubel R J
Department of Cardiothoracic-Surgery, Martin-Luther University Halle-Wittenberg, Ernst-Grube Str 40, Halle, Germany.
Exp Gerontol. 2007 Jul;42(7):668-75. doi: 10.1016/j.exger.2007.03.006. Epub 2007 Mar 27.
A decline in the function of all organs can be detected during ageing. Although the trend appears to be stable, deviation within the elderly population is much greater in comparison to young controls. The aim of the study was to identify a marker of senescence which correlates to heart function. Advanced glycation endproducts (AGEs) accumulate with age and are associated with degenerative diseases.
Carboxymethyllysine (CML) concentrations in the pericardial fluid (as a measure of AGEs) were analysed with ELISA technique in 75 patients undergoing cardiac surgery and correlated with clinical parameters and outcome of these patients.
CML content of pericardial fluid increases significantly with age. AGEs show an inverse correlation to left ventricular ejection fraction. High CML levels correlate with poor outcome of patients as shown by adverse cardiac events, prolonged ventilation time and prolonged stay within the Intensive Care Unit. Within all parameters, AGE concentration of the pericardial fluid fits better with the outcome of the patients in comparison to age alone. Interestingly, medical treatment with nitrates correlates with increased CML content.
AGEs, in addition to being a marker of senescence, appear to represent a prognostic factor in cardiac surgery, which can be used as a predictor of patient outcome.
衰老过程中可检测到所有器官功能的衰退。尽管这种趋势似乎是稳定的，但与年轻对照组相比，老年人群中的偏差要大得多。本研究的目的是确定一种与心脏功能相关的衰老标志物。晚期糖基化终产物（AGEs）会随着年龄的增长而积累，并与退行性疾病有关。
采用酶联免疫吸附测定（ELISA）技术分析了75例接受心脏手术患者心包液中的羧甲基赖氨酸（CML）浓度（作为AGEs的一种衡量指标），并将其与这些患者的临床参数和预后进行关联分析。
心包液中的CML含量随年龄显著增加。AGEs与左心室射血分数呈负相关。高CML水平与患者的不良预后相关，如心脏不良事件、通气时间延长和在重症监护病房停留时间延长。在所有参数中，与单独的年龄相比，心包液中的AGE浓度与患者的预后更相符。有趣的是，硝酸盐药物治疗与CML含量增加有关。
AGEs除了是衰老的标志物外，似乎还是心脏手术中的一个预后因素，可作为患者预后的预测指标。
