冠心病患者血浆中新型气体信号分子硫化氢的变化

摘要/Abstract

摘要： 目的探讨新型气体信号分子硫化氢(H₂S)在冠心病患者血浆中含量的差异及其病理生理意义。方法采用硫敏感电极法测定40例冠心病患者及17例造影正常者血浆H₂S含量,并在冠心病患者分析不同临床亚型及不同冠脉病变类型血浆H₂S含量的差异、血浆H₂S含量与冠心病危险因素的关系。结果 (1)冠心病患者血浆H₂S含量[(26.10±14.27)μmol/L]远低于冠脉造影正常对照组[(51.74±11.94)μmol/L,P<0.01];(2)在冠心病患者中,不稳定型心绞痛患者血浆H₂S含量[(23.60±14.41)μmol/L]和急性心肌梗死患者血浆H₂S含量[(19.98±7.516)μmol/L],明显低于稳定型心绞痛患者[(38.41±14.53)μmol/L,P<0.05]。(3)冠脉双支和多支病变组血浆H₂S含量分别为(16.91±7.98)μmol/L、(18.39±7.78)μmol/L,两组间无明显差异(P>0.05),但均明显低于单支病变组(33.04±15.01)μmol/L(P<0.05和P<0.01)。冠脉血管有闭塞的其血浆H₂S含量明显低于单纯狭窄组[(19.04±9.55)μmol/Lvs(28.24±14.85)μmol/L,P<0.05]。(4)在冠心病患者中,吸烟者血浆H₂S含量明显低于不吸烟者[(27.54±10.37)μmol/Lvs(32.24±15.77)μmol/LP<0.05],高血压病者含量明显低于无高血压病者[(20.36±8.69)μmol/Lvs(33.77±15.86)μmol/L P<0.01];血浆H₂S水平与血糖水平呈强负相关(r=-0.4936 P=0.0016),与性别、年龄、胆固醇、甘油三酯、极低密度脂蛋白、高密度脂蛋白、体质量指数等无明显相关性。结论血浆中H₂S含量降低可能与冠心病临床病情严重性及冠脉血管病变程度相关;血浆H₂S含量的减少可能与冠心病危险因素吸烟、高血压、高血糖相关。

Abstract: Objective To investigate the changes of plasma hydrogen sulfide (H₂S) in patients with coronary heart disease (CHD). Methods Plasma H₂S levels were measured in 40 patients with CHD and 17 angiographically normal patients by sulfide-sensitive electrodes, and the variation of plasma H₂S levels was analyzed in different clinical types of CHD and in different types of coronary artery lesions. The association of plasma H₂S levels with the risk factors of CHD was also analyzed. Results Plasma H₂S levels were significantly lowered in CHD patients in comparison with that in angiographically normal control subjects (26.10±14.27 μmol/L vs 51.74±11.94 μmol/L, P<0.001). In CHD patients, plasma H₂S levels in unstable angina patients (UAP, 23.60±14.41 μmol/L) and acute myocardial infarction patients (AMI, 19.98±7.516 μmol/L) were significantly lower than that in stable angina patients (SAP, 38.41±14.53 μmol/L, P<0.05). No significant difference in plasma H₂S levels was found between CHD patients with double-vessel and multi-vessel lesions (16.91±7.98 vs 18.39±7.78 μmol/L, P>0.05), but the two groups of patients had significantly lower plasma H₂S levels than patients with single-vessel involve- ment (33.04±15.01 μmol/L, P<0.05 and P<0.01, respectively). Plasma H₂S level was significantly lower in CHD patients with coronary artery occlusion than in patients with simple stenosis (19.04±9.55 vs 28.24±14.85 μmol/L, P<0.05). Among the CHD patients, H₂S levels were significantly lower in smokers than in non-smokers (27.54±10.37 vs 32.24±15.77 μmol/L, P<0.05), also lower in hypertensive patients than in normotensive patients (20.36±8.69 vs 33.77±15.86 μmol/L, P<0.01). Plasma H₂S levels showed a significant inverse correlation with blood glucose (r=-0.493 6, P=0.001 6), but there were no significant correlations with sex, age, cholesterol, triglyeride, TC, low-density lipoprotein, high-density lipoprotein, or body mass index. Conclusion Decreased plasma H₂S levels may correlate with the severity of CHD and changes of the coronary artery, and may implicate the risk factors of CHD such as smoking, hypertension, and high blood glucose.

中图分类号:

R541.4

江海龙¹, 吴宏超¹, 李志梁¹, 耿彬², 唐朝枢². 冠心病患者血浆中新型气体信号分子硫化氢的变化[J]. 南方医科大学学报, 2005, 25(08): 951-954.

JIANG Hai-long¹, WU Hong-chao¹, LI Zhi-liang¹, GENG Bin², TANG Chao-shu². Changes of the new gaseous transmitter H₂S in patients with coronary heart disease[J]. Journal of Southern Medical University, 2005, 25(08): 951-954.

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