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目的研究新型气体信号分子硫化氢(H2S)及一氧化氮(NO)在冠心病患者和冠脉造影正常者血浆中含量的差异及介入治疗对其的影响,探讨其在冠心病发病及介入治疗中的病理生理意义。方法冠心病组40例,造影正常组17例,采用硫敏感法测定术前血浆H2S含量并用Greiss法测定血浆中NO含量,动态监测冠心病患者冠状动脉造影前后、介入治疗后即刻、术后24h和72h血浆H2S、NO含量,分析冠心病组和造影正常组患者血浆H2S、NO含量的差异及介入治疗后血浆H2S和NO的变化。结果冠心病患者血浆H2S、NO含量远低于造影正常组(P均<0.01);冠脉双支和多支病变组血浆H2S含量差异无统计学意义(P>0.05),但均明显低于单支病变组(P<0.05和P<0.01)。不同支数病变冠心病患者血浆NO含量差异无统计学意义。冠脉血管有闭塞组其血浆H2S、NO含量明显低于单纯狭窄组(P均<0.05);支架植入术后复查狭窄者NO含量明显低于无狭窄者(P<0.05),H2S含量也低于无狭窄者,但差异无统计学意义(P>0.05)。冠状动脉造影术对血浆H2S、NO含量无影响,但PCI治疗术后即刻H2S、NO含量显著降低;H2S含量术后24h恢复至术前水平,NO含量术后24h降至最低水平,72h仍未恢复至术前水平。结论 H2S和NO可能参与了冠心病的发病过程及介入治疗后急性血管闭塞及再狭窄的发生,血浆H2S含量的高低与冠脉血管病变严重程度相关。
Objective To study the differences of the contents of H2S and NO in the plasma of patients with coronary heart disease and normal coronary angiography and the influence of interventional therapy on the plasma concentrations of H2S and NO in patients with coronary heart disease and interventional therapy In the pathophysiological significance. Methods 40 cases of coronary heart disease group, 17 cases of normal contrast group, the use of sulfur-sensitive plasma H2S levels were measured before plasma and Greiss method for the determination of plasma NO content, dynamic monitoring of coronary heart disease before and after coronary angiography, interventional treatment immediately after 24h And plasma H2S and NO at 72h. The plasma levels of H2S and NO in patients with coronary heart disease and normal angiography were analyzed. The changes of plasma H2S and NO after interventional therapy were also analyzed. Results The levels of plasma H2S and NO in patients with coronary heart disease were significantly lower than those in patients with normal angiography (P <0.01). There was no significant difference in plasma H2S levels between patients with double coronary artery disease and multiple coronary artery disease (P> 0.05) Single vessel disease group (P <0.05 and P <0.01). There was no significant difference in plasma NO content in patients with different count coronary artery disease. The contents of H2S and NO in plasma of patients with coronary artery occlusion were significantly lower than those of patients with simple coronary artery stenosis (all P <0.05). The content of NO in patients with coronary artery stenosis was significantly lower than those without stenosis (P <0.05) Lower than those without stenosis, but the difference was not statistically significant (P> 0.05). Coronary angiography had no effect on the content of H2S and NO in plasma, but the content of H2S and NO decreased significantly after PCI. The content of H2S returned to the preoperative level at 24h, the content of NO decreased to the lowest level at 24h, Return to preoperative level. Conclusions H2S and NO may be involved in the pathogenesis of coronary heart disease and acute vascular occlusion and restenosis after interventional therapy. The level of plasma H2S is correlated with the severity of coronary artery disease.