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目的通过检测血清可溶性E-选择素(sEsel)、晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、超氧化物歧化酶(SOD)和氧化低密度脂蛋白(ox-LDL)水平,探讨老年急性冠脉综合征(ACS)患者sEsel与氧化应激的相关性。方法选择老年ACS患者共70例,其中非ST段抬高ACS(NSTEMI/UAP)组40例,ST段抬高ACS(STEMI)组30例作为研究对象,健康自愿者36例作为对照。采用ELISA双抗体夹心法检测sEsel和ox-LDL水平,分光光度计法检测AOPP浓度,硫代巴比妥酸法和黄嘌呤氧化酶法分别测定MDA含量和SOD活力。采用双变量相关分析评价sEsel与氧化应激相关指标的相关性,并记录4周内所有患者的病情转归情况。结果老年ACS中,NSTEMI/UAP组和STEMI组的sE-sel、AOPP、MDA、SOD和ox-LDL水平均明显高于健康对照组(P<0.01),其中NSTEMI和UAP亚组间各项指标差异无统计学意义(P>0.05)。STEMI组sEsel、AOPP和ox-LDL水平均高于NSTEMI/UAP组(P<0.05),而MDA、SOD水平两组间差异无统计学意义(P>0.05)。STEMI组中冠状动脉单支病变亚组与多支病变亚组相比,各项指标均明显增高(P<0.05)。双变量相关分析显示老年ACS的sEsel与AOPP(r=0.496,P=0.000)和ox-LDL(r=0.342,P=0.000)密切相关。另外发现sEsel浓度高者病情转归及预后差,低者病情转归及预后良好。结论老年ACS发生时具有明显的氧化应激反应,sEsel的增高可能与AOPP和ox-LDL有关。sEsel对病情转归有一定预测意义。
Objective To investigate the serum levels of sEsel, AOPP, MDA, SOD and ox-LDL Correlation between sEsel and oxidative stress in elderly patients with acute coronary syndrome (ACS). Methods A total of 70 patients with senile ACS were enrolled in this study. Forty patients with non-ST-segment elevation ACS (NSTEMI / UAP), 30 with ST-segment elevation ACS (STEMI), and 36 healthy volunteers served as controls. The levels of sEsel and ox-LDL were detected by ELISA double antibody sandwich method. The concentration of AOPP was measured by spectrophotometer. The content of MDA and the activity of SOD were determined by thiobarbituric acid method and xanthine oxidase method respectively. Bivariate correlation analysis was used to evaluate the correlation between sEsel and oxidative stress-related parameters and the prognosis of all patients within 4 weeks was recorded. Results The levels of sE-sel, AOPP, MDA, SOD and ox-LDL in NSTEMI / UAP group and STEMI group were significantly higher than those in healthy control group (P <0.01) The difference was not statistically significant (P> 0.05). The levels of sEsel, AOPP and ox-LDL in STEMI group were higher than those in NSTEMI / UAP group (P <0.05), while there was no significant difference between the two groups (P> 0.05). Compared with multivessel disease subgroups, the single coronary artery disease subgroups in STEMI group were significantly increased (P <0.05). Bivariate analysis showed that sEsel in elderly ACS was closely related to AOPP (r = 0.496, P = 0.000) and ox-LDL (r = 0.342, P = 0.000). Also found that the highest concentration of sEsel outcome and poor prognosis, the prognosis and prognosis of the less favorable. Conclusion There is a significant oxidative stress response in senile ACS. The increase of sEsel may be related to AOPP and ox-LDL. sEsel on the prognosis of the disease has some predictive significance.