Kleinfeld A M, Prothro D, Brown D L, Davis R C, Richieri G V, DeMaria A
Medical Biology Institute, University of California at San Diego, La Jolla, USA.
Am J Cardiol. 1996 Dec 15;78(12):1350-4. doi: 10.1016/s0002-9149(96)00651-0.
Serum unbound free fatty acid levels (FFAu) were measured in patients undergoing percutaneous transluminal coronary angioplasty (PTCA) using the fluorescent probe acrylodan intestinal fatty acid binding protein (ADIFAB). These are the first measurements of FFAu, under nonphysiologic conditions. In these studies, FFAu, levels were determined in 22 patients 5 minutes before and 30 minutes after the procedure. Post-PTCA FFAu, levels were higher than pre-PTCA levels in all patients. The average post-PTCA level for all patients was 103 nM, about 14-fold higher than the 7.5 nM value observed in healthy subjects. Although all patients exhibited elevated FFAu levels after PTCA, ischemic ST-segment changes were observed in only 11 of these patients. The average post-PTCA FFAu levels for patients with significant ST-segment changes (123 nM) were significantly higher than those in patients who did not exhibit such changes (47 nM). Average FFAu (22 nM) levels before the procedure were elevated in the patient population relative to healthy subjects and these values correlated positively with post-PTCA levels. These results suggest that increased serum FFAu levels reflect angioplasty-induced ischemia and that FFAu levels may provide a more sensitive measure of ischemia than electrocardiographic measurements. Moreover, because 30% of these patients had post-PTCA FFAu concentrations exceeding those found to alter in vitro cell function, the increased serum FFAu levels that accompany ischemia may be deleterious for myocardial function.
采用荧光探针丙烯罗丹明肠脂肪酸结合蛋白（ADIFAB），对接受经皮腔内冠状动脉成形术（PTCA）的患者的血清非结合游离脂肪酸水平（FFAu）进行了测量。这是在非生理条件下首次对FFAu进行的测量。在这些研究中，测定了22例患者在手术前5分钟和手术后30分钟的FFAu水平。所有患者术后FFAu水平均高于术前。所有患者术后的平均水平为103 nM，约为健康受试者中观察到的7.5 nM值的14倍。尽管所有患者在PTCA术后FFAu水平均升高，但其中只有11例患者出现了缺血性ST段改变。有明显ST段改变的患者术后平均FFAu水平（123 nM）显著高于未出现此类改变的患者（47 nM）。相对于健康受试者，该患者群体术前的平均FFAu（22 nM）水平升高，且这些值与术后水平呈正相关。这些结果表明，血清FFAu水平升高反映了血管成形术诱发的缺血，并且FFAu水平可能比心电图测量提供更敏感的缺血指标。此外，由于这些患者中有30%术后FFAu浓度超过了在体外细胞功能中发现会改变的值，伴随缺血的血清FFAu水平升高可能对心肌功能有害。
