中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
2期
145-148
,共4页
马建林%马立宁%张银环%张家明%李大主%林劲%张敬文%王圣%苏哲坦
馬建林%馬立寧%張銀環%張傢明%李大主%林勁%張敬文%王聖%囌哲坦
마건림%마립저%장은배%장가명%리대주%림경%장경문%왕골%소철탄
不稳定型心绞痛%高血压病%P-选择素%相关因素
不穩定型心絞痛%高血壓病%P-選擇素%相關因素
불은정형심교통%고혈압병%P-선택소%상관인소
Unstable angina pectoris%Hypertension%P-selectin%Related factions
目的 观察不稳定型心绞痛合并高血压病患者血浆和血小板P-选择素变化,并分析其意义.方法 选择心绞痛患者116例,其中单纯稳定型心绞痛患者36例为稳定型心绞痛组,单纯不稳定型心绞痛患者38例为不稳定型心绞痛组,不稳定型心绞痛合并高血压病组42例;选择与心绞痛患者性别、年龄相匹配的同期行冠状动脉造影健康者48例作为对照组.分别测定血浆和血小板内P-选择素含量以及血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、超氧化物歧化酶、丙二醛含量,分析P-选择素与血脂、脂质过氧化物的相关性.结果 不稳定型心绞痛合并高血压病组患者血浆及血小板内P-选择素水平明显高于对照组、稳定型心绞痛组以及不稳定型心绞痛组[血浆P-选择素为(16.9±4.2) μg/L比(12.5±2.9)、(12.9±3.0)、(14.9±3.2) μg/L,均P＜0.01;血小板P-选择素分别为(1.46±0.21)×104分子/血小板比(0.80±0.18)、(0.86±0.20)、(1.28 ±0.19) ×104分子/血小板,P＜0.05或P＜0.01];不稳定型心绞痛组血浆及血小板内P-选择素也明显高于对照组及稳定型心绞痛组(P ＜0.05或P＜0.01);而稳定型心绞痛组血浆及血小板内P-选择素含量与对照组差异无统计学意义(P＞0.05).对照组总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、丙二醛、超氧化物歧化酶分别为(4.98±0.76) mmol/L、(1.34±0.36) mmol/L、(1.23±0.40) mmol/L、(3.19±0.56) mmol/L、(0.15±0.05) nmol/L、(83±22) kIU/L;稳定型心绞痛组分别为(5.41±0.76) mmol/L、(1.59±0.38) mmol/L、(1.18±0.44) mmol/L、(3.64±0.54) mmol/L、(0.22±0.06) nmol/L、(70±20) kIU/L;单纯不稳定型心绞痛组分别为(5.46±0.82) mmol/L、(1.60±0.37) mmol/L、(1.14±0.45) mmol/L、(3.69±0.58) mmol/L、(0.29±0.06) nmol/L、(59±20) kIU/L;不稳定型心绞痛并高血压病组总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、丙二醛、超氧化物歧化酶分别为(5.51±0.86) mmol/L、(1.60±0.40) mmol/L、(1.15±0.41) mmol/L、(3.78±0.66) mmol/L、(0.36±0.08) nmol/L、(89±29) kIU/L.稳定型心绞痛组、不稳定型心绞痛组与不稳定型心绞痛合并高血压病组总胆固醇、三酰甘油、低密度脂蛋白胆固醇和丙二醛明显高于对照组,差异均有统计学意义(P＜0.05或P＜0.01),不稳定型心绞痛组与不稳定型心绞痛合并高血压病组超氧化物歧化酶高于对照组和稳定型心绞痛组(P ＜0.05或P＜0.01).血浆P-选择素与总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、丙二醛、血小板P-选择素呈正相关,r分别为0.187、0.422、0.457、0.193、0.566、0.669,均P＜0.01;与超氧化物歧化酶呈负相关,r=-0.465,P＜0.01.结论 不稳定型心绞痛患者体内P-选择素含量明显升高,这在合并高血压病者最为明显,且其含量与血脂及脂质过氧化物密切相关,说明其体内血小板活性明显增强,其原理可能与脂质代谢紊乱以及氧化应激增强有关.
目的 觀察不穩定型心絞痛閤併高血壓病患者血漿和血小闆P-選擇素變化,併分析其意義.方法 選擇心絞痛患者116例,其中單純穩定型心絞痛患者36例為穩定型心絞痛組,單純不穩定型心絞痛患者38例為不穩定型心絞痛組,不穩定型心絞痛閤併高血壓病組42例;選擇與心絞痛患者性彆、年齡相匹配的同期行冠狀動脈造影健康者48例作為對照組.分彆測定血漿和血小闆內P-選擇素含量以及血清總膽固醇、三酰甘油、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、超氧化物歧化酶、丙二醛含量,分析P-選擇素與血脂、脂質過氧化物的相關性.結果 不穩定型心絞痛閤併高血壓病組患者血漿及血小闆內P-選擇素水平明顯高于對照組、穩定型心絞痛組以及不穩定型心絞痛組[血漿P-選擇素為(16.9±4.2) μg/L比(12.5±2.9)、(12.9±3.0)、(14.9±3.2) μg/L,均P＜0.01;血小闆P-選擇素分彆為(1.46±0.21)×104分子/血小闆比(0.80±0.18)、(0.86±0.20)、(1.28 ±0.19) ×104分子/血小闆,P＜0.05或P＜0.01];不穩定型心絞痛組血漿及血小闆內P-選擇素也明顯高于對照組及穩定型心絞痛組(P ＜0.05或P＜0.01);而穩定型心絞痛組血漿及血小闆內P-選擇素含量與對照組差異無統計學意義(P＞0.05).對照組總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、丙二醛、超氧化物歧化酶分彆為(4.98±0.76) mmol/L、(1.34±0.36) mmol/L、(1.23±0.40) mmol/L、(3.19±0.56) mmol/L、(0.15±0.05) nmol/L、(83±22) kIU/L;穩定型心絞痛組分彆為(5.41±0.76) mmol/L、(1.59±0.38) mmol/L、(1.18±0.44) mmol/L、(3.64±0.54) mmol/L、(0.22±0.06) nmol/L、(70±20) kIU/L;單純不穩定型心絞痛組分彆為(5.46±0.82) mmol/L、(1.60±0.37) mmol/L、(1.14±0.45) mmol/L、(3.69±0.58) mmol/L、(0.29±0.06) nmol/L、(59±20) kIU/L;不穩定型心絞痛併高血壓病組總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、丙二醛、超氧化物歧化酶分彆為(5.51±0.86) mmol/L、(1.60±0.40) mmol/L、(1.15±0.41) mmol/L、(3.78±0.66) mmol/L、(0.36±0.08) nmol/L、(89±29) kIU/L.穩定型心絞痛組、不穩定型心絞痛組與不穩定型心絞痛閤併高血壓病組總膽固醇、三酰甘油、低密度脂蛋白膽固醇和丙二醛明顯高于對照組,差異均有統計學意義(P＜0.05或P＜0.01),不穩定型心絞痛組與不穩定型心絞痛閤併高血壓病組超氧化物歧化酶高于對照組和穩定型心絞痛組(P ＜0.05或P＜0.01).血漿P-選擇素與總膽固醇、三酰甘油、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、丙二醛、血小闆P-選擇素呈正相關,r分彆為0.187、0.422、0.457、0.193、0.566、0.669,均P＜0.01;與超氧化物歧化酶呈負相關,r=-0.465,P＜0.01.結論 不穩定型心絞痛患者體內P-選擇素含量明顯升高,這在閤併高血壓病者最為明顯,且其含量與血脂及脂質過氧化物密切相關,說明其體內血小闆活性明顯增彊,其原理可能與脂質代謝紊亂以及氧化應激增彊有關.
목적 관찰불은정형심교통합병고혈압병환자혈장화혈소판P-선택소변화,병분석기의의.방법 선택심교통환자116례,기중단순은정형심교통환자36례위은정형심교통조,단순불은정형심교통환자38례위불은정형심교통조,불은정형심교통합병고혈압병조42례;선택여심교통환자성별、년령상필배적동기행관상동맥조영건강자48례작위대조조.분별측정혈장화혈소판내P-선택소함량이급혈청총담고순、삼선감유、저밀도지단백담고순、고밀도지단백담고순、초양화물기화매、병이철함량,분석P-선택소여혈지、지질과양화물적상관성.결과 불은정형심교통합병고혈압병조환자혈장급혈소판내P-선택소수평명현고우대조조、은정형심교통조이급불은정형심교통조[혈장P-선택소위(16.9±4.2) μg/L비(12.5±2.9)、(12.9±3.0)、(14.9±3.2) μg/L,균P＜0.01;혈소판P-선택소분별위(1.46±0.21)×104분자/혈소판비(0.80±0.18)、(0.86±0.20)、(1.28 ±0.19) ×104분자/혈소판,P＜0.05혹P＜0.01];불은정형심교통조혈장급혈소판내P-선택소야명현고우대조조급은정형심교통조(P ＜0.05혹P＜0.01);이은정형심교통조혈장급혈소판내P-선택소함량여대조조차이무통계학의의(P＞0.05).대조조총담고순、삼선감유、고밀도지단백담고순、저밀도지단백담고순、병이철、초양화물기화매분별위(4.98±0.76) mmol/L、(1.34±0.36) mmol/L、(1.23±0.40) mmol/L、(3.19±0.56) mmol/L、(0.15±0.05) nmol/L、(83±22) kIU/L;은정형심교통조분별위(5.41±0.76) mmol/L、(1.59±0.38) mmol/L、(1.18±0.44) mmol/L、(3.64±0.54) mmol/L、(0.22±0.06) nmol/L、(70±20) kIU/L;단순불은정형심교통조분별위(5.46±0.82) mmol/L、(1.60±0.37) mmol/L、(1.14±0.45) mmol/L、(3.69±0.58) mmol/L、(0.29±0.06) nmol/L、(59±20) kIU/L;불은정형심교통병고혈압병조총담고순、삼선감유、고밀도지단백담고순、저밀도지단백담고순、병이철、초양화물기화매분별위(5.51±0.86) mmol/L、(1.60±0.40) mmol/L、(1.15±0.41) mmol/L、(3.78±0.66) mmol/L、(0.36±0.08) nmol/L、(89±29) kIU/L.은정형심교통조、불은정형심교통조여불은정형심교통합병고혈압병조총담고순、삼선감유、저밀도지단백담고순화병이철명현고우대조조,차이균유통계학의의(P＜0.05혹P＜0.01),불은정형심교통조여불은정형심교통합병고혈압병조초양화물기화매고우대조조화은정형심교통조(P ＜0.05혹P＜0.01).혈장P-선택소여총담고순、삼선감유、저밀도지단백담고순、고밀도지단백담고순、병이철、혈소판P-선택소정정상관,r분별위0.187、0.422、0.457、0.193、0.566、0.669,균P＜0.01;여초양화물기화매정부상관,r=-0.465,P＜0.01.결론 불은정형심교통환자체내P-선택소함량명현승고,저재합병고혈압병자최위명현,차기함량여혈지급지질과양화물밀절상관,설명기체내혈소판활성명현증강,기원리가능여지질대사문란이급양화응격증강유관.
Objective To study the changes of P-selectin in unstable angina pectoris (UAP) patients with hypertension(HBP).Methods One hundred and sixteen patients with angina pectoris were as experiment group,including 36 patients with stable angina pectoris(SAP group),38 patients with UAP(UAP group) and 42 UAP patients with HBP(UAP and HBP group).48 normal persons were as control group.Levels of plasma and platelet P-selectin,blood lipid [total cholesterol (TC),triacylglycerol (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol(HDL-C)],malonyldiadehyde (MDA) and superoxide dismutase(SOD) were analyzed in all cases.Results The levels of plasma and platelet P-selectin in UAP and HBP group were markedly higher than those in control group and SAP group as well as UAP group [plasma was (16.9 ± 4.2) μg/L vs (12.5 ± 2.9),(12.9 ± 3.0),(14.9 ± 3.2) μg/L,all P ＜ 0.01 ; platelet P-selectin was (1.46 ± 0.21) × 104/BPC vs(0.80 ±0.18),(0.86 ±0.20),(1.28 ±0.19) × 104/BPC,P ＜0.05 or P ＜0.01].The levels of those parameters in UAP group were markedly higher than those in control group as well as SAP group (P ＜ 0.01).Compared with those in the normal cases,the levels of plasma and platelet P-selectin were not significantly changed in SAP group(P ＞ 0.05).TC,TG,HDL-C,LDL-C,MDA,SOD in control group were (4.98 ± 0.76) mmol/L,(1.34 ±0.36) mmol/L,(1.23 ± 0.40) mmol/L,(3.19 ± 0.56) mmol/L,(0.15 ± 0.05) nmol/L,(89 ± 29) kIU/L,respectively; those in SAP group were (5.41 ± 0.76) mmol/L,(1.59 ± 0.38) mmol/L,(1.18 ± 0.44) mmol/L,(3.64 ±0.54) mmol/L,(0.22 ± 0.06) nmol/L,(84 ± 22) kIU/L,respectively; Those in UAP group were (5.46 ± 0.82) mmol/L,(1.60 ± 0.37) mmol/L,(1.14 ± 0.45) mmol/L,(3.69 ± 0.58) mmol/L,(0.29 ± 0.06) nmol/L,(70 ±20) kIU/L,respectively;Those in UAP and HBP group were(5.51 ±0.86) mmol/L,(1.60 ±0.40) mmol/L,(1.15 ± 0.41) mmol/L,(3.78 ± 0.66) mmol/L,(0.36 ± 0.08) nmol/L,(59 ± 20) kIU/L,respectively.TC,TG,LDL-C,MDA in SAP group,UAP group,UAP and HBP group were higher than those in control group(P ＜ 0.05or P ＜ 0.01),SOD in UAP group,UAP and HBP group were higher than those in control group and SAP group (P ＜ 0.05 or P ＜ 0.01).Regression analysis showed that there were positive conrelations between plasma P-selectin and platelet P-seleetin,TG,LDL-C,MDA(r =0.187,0.422,0.457,0.193,0.566,0.699,all P ＜0.01),and negative correlations between plasma P-selectin and SOD (r =-0.465,P ＜ 0.01) in UAP group.Conclusion The levels of P-selectin are significantly elevated in old patients with UAP,especially in those with HBP,and the changes are closely related with blood lipid and peroxidate,suggesting that there is an activation of platelet which may be related with lipid metabolism and oxidative stress.
