Ragab M, Hassan H, Zaytoun T, Refai W, Rocks B, Elsammak M
Departments of Chemical Pathology and.
Exp Clin Cardiol. 2005 Winter;10(4):250-5.
The present study evaluated serum neopterin, high-sensitivity C-reactive protein (hs-CRP) and thiobarbituric acid reactive substances (TBARS) in Egyptian patients with acute coronary artery disease. Thirty-six patients with unstable angina aged (mean +/- SD) 61.3+/-9.4 years, 29 patients with myocardial infarction aged 58.2+/-8.7 years and 24 sex- and age-matched control subjects were included in the study. Neopterin levels were significantly higher in patients with myocardial infarction and those with unstable angina than in the healthy control group (P<0.001). The serum level of neopterin in the control group (median [range]) was 3.25 nmol/L (1.25 nmol/L to 5.4 nmol/L), whereas in patients with unstable angina and those with myocardial infarction, neopterin levels were 10.4 nmol/L (3.5 nmol/L to 15.2 nmol/L) and 12.6 nmol/L (3.25 nmol/L to 17.8 nmol/L), respectively. Levels of hs-CRP and TBARS were also significantly higher in patients with unstable angina and those with myocardial infarction than in the healthy control group (P<0.01). The medians (ranges) of hs-CRP were 4.8 mg/L (2.5 mg/L to 9.9 mg/L), 12.0 mg/L (4.6 mg/L to 31.0 mg/L) and 12.3 mg/L (7.5 mg/L to 32.1 mg/L) in the control group, patients with unstable angina and those with myocardial infarction, respectively. The means +/- SD of TBARS in the control group, patients with unstable angina and those with myocardial infarction were 0.64+/-0.17 mumol/L, 1.17+/-0.31 mumol/L and 1.17+/-0.49 mumol/L, respectively. TBARS positively correlated with hs-CRP and neopterin levels. Furthermore, when both patients and controls were classified according to their smoking status, significantly higher levels of neopterin and TBARS were found in the smokers of each subgroup than in the nonsmokers.In conclusion, the present study found a higher level of neopterin, hs-CRP and TBARS in patients with coronary artery disease. Serum neopterin and hs-CRP positively correlated with the level of TBARS. The authors suggest that triggering factors (eg, smoking, high cholesterol, elevated body mass index or raised blood pressure) may lead to increased oxidative stress, which induces an inflammatory insult leading to higher levels of inflammatory markers such as neopterin and hs-CRP.
本研究评估了埃及急性冠状动脉疾病患者的血清新蝶呤、高敏C反应蛋白（hs-CRP）和硫代巴比妥酸反应物质（TBARS）。研究纳入了36例不稳定型心绞痛患者，年龄（均值±标准差）为61.3±9.4岁；29例心肌梗死患者，年龄为58.2±8.7岁；以及24名性别和年龄匹配的对照者。心肌梗死患者和不稳定型心绞痛患者的新蝶呤水平显著高于健康对照组（P<0.001）。对照组的血清新蝶呤水平（中位数[范围]）为3.25 nmol/L（1.25 nmol/L至5.4 nmol/L），而不稳定型心绞痛患者和心肌梗死患者的新蝶呤水平分别为10.4 nmol/L（3.5 nmol/L至15.2 nmol/L）和12.6 nmol/L（3.25 nmol/L至17.8 nmol/L）。不稳定型心绞痛患者和心肌梗死患者的hs-CRP和TBARS水平也显著高于健康对照组（P<0.01）。对照组、不稳定型心绞痛患者和心肌梗死患者的hs-CRP中位数（范围）分别为4.8 mg/L（2.5 mg/L至9.9 mg/L）、12.0 mg/L（4.6 mg/L至31.0 mg/L）和12.3 mg/L（7.5 mg/L至32.1 mg/L）。对照组、不稳定型心绞痛患者和心肌梗死患者的TBARS均值±标准差分别为0.64±0.17 μmol/L、1.17±0.31 μmol/L和1.17±0.49 μmol/L。TBARS与hs-CRP和新蝶呤水平呈正相关。此外，根据吸烟状况对患者和对照者进行分类时，各亚组吸烟者的新蝶呤和TBARS水平均显著高于非吸烟者。总之，本研究发现冠状动脉疾病患者的新蝶呤、hs-CRP和TBARS水平较高。血清新蝶呤和hs-CRP与TBARS水平呈正相关。作者认为触发因素（如吸烟、高胆固醇、体重指数升高或血压升高）可能导致氧化应激增加，进而引发炎症损伤，导致新蝶呤和hs-CRP等炎症标志物水平升高。
