中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
24期
2898-2902
,共5页
袁媛%谷翔%黄问银%唐新虎
袁媛%穀翔%黃問銀%唐新虎
원원%곡상%황문은%당신호
冠心病%硫氧还蛋白还原酶%肿瘤坏死因子α%超敏C反应蛋白
冠心病%硫氧還蛋白還原酶%腫瘤壞死因子α%超敏C反應蛋白
관심병%류양환단백환원매%종류배사인자α%초민C반응단백
Coronary disease%Thioredoxin reductase%Tumor necrosis factor -alpha%Ultra -sensitivity C-reactive protein
目的：探讨血清硫氧还蛋白还原酶（ TrxR）在不同类型冠心病患者中的水平，分析其与炎性因子的关联，探讨其在冠心病病理过程中的作用及可能机制。方法选择2011年12月—2012年12月在九江学院附属医院心血管内科住院并经冠状动脉造影确诊为冠心病的患者115例，其中稳定型心绞痛（ SAP ）组37例、不稳定型心绞痛（ UAP）组37例、急性心肌梗死（ AMI）组41例，同期另选择40例体检健康者作为对照组。根据Gensini评分系统对冠状动脉病变血管狭窄程度进行定量分析；并分别采用酶联免疫吸附试验与乳胶免疫比浊法检测血清中TrxR、肿瘤坏死因子α（ TNF-α）与超敏C反应蛋白（ hs-CRP）水平。分别比较各组TrxR水平及其与炎性因子和Gensini评分的相关性。结果4组血清TrxR、 TNF-α、 hs-CRP水平比较，差异均有统计学意义（ P＜0.05）；其中与对照组比较， SAP组、 UAP组和AMI组TrxR水平降低， TNF-α、 hs-CRP水平升高（P＜0.05）；与SAP组比较， UAP组和AMI组TrxR水平降低， TNF-α、 hs-CRP水平升高（ P＜0.05）；与UAP组比较， AMI组TrxR水平降低， TNF-α、 hs-CRP水平升高（P＜0.05）。相关性分析结果显示，血清TrxR水平与TNF-α水平呈负相关（r＝-0.919， P＜0.001）；血清TrxR水平与hs-CRP水平呈负相关（r＝-0.885， P＜0.001）；血清TrxR水平与Gensini评分呈负相关（r＝-0.812， P＜0.001）。结论低水平的TrxR促进了冠心病的发生、发展，其机制可能是通过调节TNF-α和hs-CRP水平参与其中。
目的：探討血清硫氧還蛋白還原酶（ TrxR）在不同類型冠心病患者中的水平，分析其與炎性因子的關聯，探討其在冠心病病理過程中的作用及可能機製。方法選擇2011年12月—2012年12月在九江學院附屬醫院心血管內科住院併經冠狀動脈造影確診為冠心病的患者115例，其中穩定型心絞痛（ SAP ）組37例、不穩定型心絞痛（ UAP）組37例、急性心肌梗死（ AMI）組41例，同期另選擇40例體檢健康者作為對照組。根據Gensini評分繫統對冠狀動脈病變血管狹窄程度進行定量分析；併分彆採用酶聯免疫吸附試驗與乳膠免疫比濁法檢測血清中TrxR、腫瘤壞死因子α（ TNF-α）與超敏C反應蛋白（ hs-CRP）水平。分彆比較各組TrxR水平及其與炎性因子和Gensini評分的相關性。結果4組血清TrxR、 TNF-α、 hs-CRP水平比較，差異均有統計學意義（ P＜0.05）；其中與對照組比較， SAP組、 UAP組和AMI組TrxR水平降低， TNF-α、 hs-CRP水平升高（P＜0.05）；與SAP組比較， UAP組和AMI組TrxR水平降低， TNF-α、 hs-CRP水平升高（ P＜0.05）；與UAP組比較， AMI組TrxR水平降低， TNF-α、 hs-CRP水平升高（P＜0.05）。相關性分析結果顯示，血清TrxR水平與TNF-α水平呈負相關（r＝-0.919， P＜0.001）；血清TrxR水平與hs-CRP水平呈負相關（r＝-0.885， P＜0.001）；血清TrxR水平與Gensini評分呈負相關（r＝-0.812， P＜0.001）。結論低水平的TrxR促進瞭冠心病的髮生、髮展，其機製可能是通過調節TNF-α和hs-CRP水平參與其中。
목적：탐토혈청류양환단백환원매（ TrxR）재불동류형관심병환자중적수평，분석기여염성인자적관련，탐토기재관심병병리과정중적작용급가능궤제。방법선택2011년12월—2012년12월재구강학원부속의원심혈관내과주원병경관상동맥조영학진위관심병적환자115례，기중은정형심교통（ SAP ）조37례、불은정형심교통（ UAP）조37례、급성심기경사（ AMI）조41례，동기령선택40례체검건강자작위대조조。근거Gensini평분계통대관상동맥병변혈관협착정도진행정량분석；병분별채용매련면역흡부시험여유효면역비탁법검측혈청중TrxR、종류배사인자α（ TNF-α）여초민C반응단백（ hs-CRP）수평。분별비교각조TrxR수평급기여염성인자화Gensini평분적상관성。결과4조혈청TrxR、 TNF-α、 hs-CRP수평비교，차이균유통계학의의（ P＜0.05）；기중여대조조비교， SAP조、 UAP조화AMI조TrxR수평강저， TNF-α、 hs-CRP수평승고（P＜0.05）；여SAP조비교， UAP조화AMI조TrxR수평강저， TNF-α、 hs-CRP수평승고（ P＜0.05）；여UAP조비교， AMI조TrxR수평강저， TNF-α、 hs-CRP수평승고（P＜0.05）。상관성분석결과현시，혈청TrxR수평여TNF-α수평정부상관（r＝-0.919， P＜0.001）；혈청TrxR수평여hs-CRP수평정부상관（r＝-0.885， P＜0.001）；혈청TrxR수평여Gensini평분정부상관（r＝-0.812， P＜0.001）。결론저수평적TrxR촉진료관심병적발생、발전，기궤제가능시통과조절TNF-α화hs-CRP수평삼여기중。
Objective To investigate the serum levels of thioredoxin reductase ( TrxR) in patients with different types of coronary heart disease , to study the correlation between TrxR and inflammatory cytokines , and to explore the role of TrxR on the course of coronary heart disease and its possible mechanism .Methods A total of 115 patients who were diagnosed with coronary heart disease by coronary angiography in Department of Cardiovascular Diseases in Affiliated Hosptial of Jiujiang University from December 2011 to December 2012, were selected as study subjects , the patients were divided to 3 groups:stable angina pectoris (SAP) group (n=37), unstable angina pectoris (UAP) group (n=37), and acute myocardial infarction (AMI) group (n=41) .40 normal healthy people were included in control group .The severity of coronary atherosclerosis were determined by the the Gensini score .Gensini score system was used for quantitative analysis of the stenosis degree of coronary artery lesion vessels.The serum levels of TrxR , TNF-αand hs-CRP were tested by enzyme -linked immunosorbent assay and latex turbidimetric immunoassay .Serum levels of TrxR were compared among different groups , the correlation between TrxR and inflammatory cytokines , and correlation between TrxR and Gensini score for severity of coronary artery disease was analyzed respectively.Results There were significant differences in serum levels of TrxR , TNF-αand hs-CRP among the four groups of the patients ( P<0.05) .The serum level of TrxR in SAP group , UAP group and AMI group was significantly lower than that in control group, respectively (P<0.05); while serum levels of TNF-αand hs-CRP in SAP group, UAP group and AMI group were significantly higher than those in control group , respectively ( P<0.05) .The serum level of TrxR in UAP group and AMI group was significantly lower than that in SAP group , respectively ( P<0.05); while serum levels of TNF-αand hs-CRP in UAP group and AMI group were significantly higher than those in SAP group , respectively ( P<0.05) .The serum level of TrxR in AMI group was significantly lower than that in UAP group (P<0.05); while serum levels of TNF-αand hs-CRP in AMI group were significantly higher than those in UAP group , respectively ( P<0.05 ) .The correlation analysis results showed that serum TrxR level was negatively correlated with the TNF-αlevel (r=-0.919, P<0.001), hs-CRP level (r=-0.885, P<0.001) and Gensini coronary artery score (r=-0.812, P<0.001), respectively.Conclusion Low level of TrxR may promote the occurrence and development of coronary heart disease , TrxR may be involved in the occurrence and development of atherosclerosis by adjusting levels of TNF -αand hs-CRP.
