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目的研究不对称二甲基精氨酸(ADMA)水平是否与冠状动脉粥样硬化的病变范围和严重程度有关。方法 110例行冠状动脉造影术的患者根据造影结果分为冠状动脉造影正常的对照组22例,轻度动脉硬化组21例,造影显示冠状动脉内膜不光滑,但无明显的狭窄或狭窄小于50%;单支病变组22例,造影显示1支主要的冠状动脉分支出现明显狭窄(≥50%);双支病变组22例,两支主要的冠状动脉分支出现明显狭窄;多支病变组23例,两支以上主要的冠状动脉分支出现明显狭窄或伴有左主干病变。血浆 ADMA 水平的检测采用酶联免疫法。结果除轻度动脉硬化组 ADMA水平(1.21μmol/L±0.36μmol/L,P=0.288)偏低外,单支病变组、双支病变组和多支病变组患者的ADMA 水平均高于对照组(1.52μmol/L±0.61μmol/L,1.67μmol/L±0.80μmol/L 和2.60μmol/L±0.62μmol/L vs 0.79μmol/L±0.54μmol/L,P<0.01)。经过多元相关与 Logistic 等级回归分析,ADMA 水平与冠状动脉病变程度密切相关。结论血浆 ADMA 水平升高可以预测冠状动脉粥样硬化的发生,ADMA 可能是一种新的冠心病危险因子。
Objective To investigate whether asymmetric dimethylarginine (ADMA) levels are associated with the extent and severity of coronary atherosclerosis. Methods Totally 110 patients undergoing coronary angiography were divided into control group (n = 22) and mild arteriosclerosis group (n = 21) according to angiographic results. Angiography showed that coronary intima was not smooth, but no obvious stenosis or stenosis was less than 50%. In the single vessel disease group, 22 cases showed obvious stenosis (≥50%) in one major coronary artery branch. In the double vessel disease group, 22 cases showed obvious stenosis of the two major coronary artery branches. 23 cases, more than two major branches of coronary artery obvious stenosis or associated with left main disease. Plasma ADMA levels were measured by enzyme-linked immunosorbent assay. Results The levels of ADMA in patients with single-vessel disease, double-vessel disease and multi-vessel disease were significantly higher than those with mild low-grade arteriosclerosis (1.21 μmol / L ± 0.36 μmol / L, P = 0.288) (1.52μmol / L ± 0.61μmol / L, 1.67μmol / L ± 0.80μmol / L and 2.60μmol / L ± 0.62μmol / L vs 0.79μmol / L ± 0.54μmol / L, P <0.01). After multivariate correlation and logistic regression analysis, the level of ADMA was closely related to the degree of coronary artery disease. Conclusions Elevated plasma levels of ADMA can predict the occurrence of coronary atherosclerosis. ADMA may be a new risk factor of coronary heart disease.