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目的探讨冠心病患者氧化低密度脂蛋白(ox-LDL)变化与冠状动脉(冠脉)内皮损伤及相关临床表现的关系。方法54例冠心病患者均经冠脉造影证实有明显冠脉狭窄,测定其冠状窦和外周血中ox-LDL、一氧化氮(NO)及循环内皮细胞(CEC)数量,分为不稳定型心绞痛(UA)组和稳定型心绞痛(SA)组,比较两组与正常对照组(20例)间相同和不同部位之间指标的差异。结果UA组、SA组患者冠状窦血中NO含量较对照组明显降低,ox-LDL和CEC均明显增高。冠状窦血中NO含量均明显低于外周血,ox-LDL和CEC均明显高于外周血。对照组冠状窦与外周血相比三项指标均未见明显差别。结论冠心病患者冠脉局部ox-LDL升高与冠脉内皮损伤相关,并与冠心病病情严重程度一致,可能参与了冠心病病情恶化以及急性冠脉事件的发生。
Objective To investigate the relationship between the changes of oxidized low density lipoprotein (ox-LDL) and coronary artery (coronary) endothelial dysfunction in patients with coronary heart disease and its clinical manifestations. Methods Fifty-four patients with coronary heart disease were confirmed coronary stenosis by coronary angiography. The quantities of ox-LDL, nitric oxide (NO) and circulating endothelial cells (CEC) in coronary sinus and peripheral blood were measured and divided into unstable type Angina pectoris (UA) group and stable angina pectoris group (SA). The differences between the two groups and the normal control group (20 cases) were compared between the same and different parts. Results In the UA group and SA group, the content of NO in coronary sinus blood was significantly lower than that in the control group, while ox-LDL and CEC were significantly increased. Coronary sinus blood NO levels were significantly lower than the peripheral blood, ox-LDL and CEC were significantly higher than peripheral blood. The control group of coronary sinus and peripheral blood compared to the three indicators were no significant difference. Conclusion The elevated coronary ox-LDL in patients with coronary artery disease is associated with coronary endothelial dysfunction and is consistent with the severity of coronary heart disease. It may be involved in the worsening of coronary heart disease and the occurrence of acute coronary events.