Lo Presti Rosalia, D'Amico Teresa, Montana Maria, Canino Baldassare, Amodeo Gabriella, Ciancarelli Maria Giuliana Tozzi, Caimi Gregorio
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy.
Clin Hemorheol Microcirc. 2007;37(4):339-45.
Oxidative stress has probably a role in coronary heart disease (CHD), but studies focused on the behaviour of oxidative status in patients with stable CHD have obtained controversial results. On the other hand, an increased release of leukocyte elastase is considered a marker of CHD. Exercise can induce oxidative stress and leukocyte activation, so the aim of this study was to evaluate oxidative status and plasma elastase level in a group of subjects with stable coronary heart disease (CHD), at baseline and during an exercise test. We enrolled 15 patients with previous acute myocardial infarction, all treated with statins and platelet antiaggregating agents. As parameters of oxidative status we determined the thiobarbituric acid reactive substances and total antioxidant status (TAS). The exercise test was performed according to the Bruce protocol. At baseline, elastase level was higher in CHD subjects than in normal controls and during the exercise test it increased in both groups in comparison with basal values. Regarding oxidative status, only TAS was slightly lower in CHD subjects than in normal controls. In both groups, during exercise test, no parameter of oxidative status was significantly different compared to basal values. In conclusion, CHD patients showed, at rest, an abnormal neutrophil activation and a lower antioxidant status. The exercise test further activated neutrophils but did not influence oxidative status. The absence of a marked oxidative stress in our patients may be partly due to the pharmacological treatment, which apparently did not influence the abnormal leukocyte activation.
氧化应激可能在冠心病（CHD）中起作用，但针对稳定型冠心病患者氧化状态行为的研究结果存在争议。另一方面，白细胞弹性蛋白酶释放增加被认为是冠心病的一个标志物。运动可诱导氧化应激和白细胞活化，因此本研究的目的是评估一组稳定型冠心病（CHD）患者在基线和运动试验期间的氧化状态及血浆弹性蛋白酶水平。我们纳入了15例既往有急性心肌梗死病史的患者，所有患者均接受他汀类药物和血小板抗聚集药物治疗。作为氧化状态的参数，我们测定了硫代巴比妥酸反应性物质和总抗氧化状态（TAS）。运动试验按照布鲁斯方案进行。在基线时，冠心病患者的弹性蛋白酶水平高于正常对照组，在运动试验期间，两组的弹性蛋白酶水平均较基础值升高。关于氧化状态，冠心病患者仅TAS略低于正常对照组。在两组中，运动试验期间，氧化状态的各项参数与基础值相比均无显著差异。总之，冠心病患者在静息时表现出异常的中性粒细胞活化和较低的抗氧化状态。运动试验进一步激活了中性粒细胞，但未影响氧化状态。我们的患者未出现明显的氧化应激可能部分归因于药物治疗，药物治疗显然未影响异常的白细胞活化。
