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目的了解充血与缺血性心力衰竭(HF)时超氧化物歧化酶(SOD)及其相关微量元素细胞内外变化特征,为HF患者微量元素治疗提供依据。方法用放射免疫法测定27例急诊HF患者维生素C抗氧化治疗前后血清SOD,用日立180-80原子吸收分光光度计测定血浆及红细胞内外微量元素Cu,Zn,Se,Fe。结果充血性HF(CHF)与缺血性心脏病伴心功能不全患者[缺血性HF(IHF)]及二者与正常组比较SOD均无显著差异。CHF治疗前后红细胞Se,Fe,Cu与正常组比较差异显著(P<0.01),治疗前后血浆Zn降低、Cu升高,与正常组比较差异显著(P<0.01)。治疗前血浆Se与正常组比较降低且有显著差异(P<0.05)。IHF治疗前后红细胞Se,Fe,Cu与正常组比较均降低且差异显著(P<0.01),治疗前后血浆Cu升高、Zn降低,与正常组比较差异显著(P<0.01)。IHF红细胞治疗后较治疗前Cu升高、Zn降低(均P<0.05)。IHF治疗前血浆Cu低于CHF组(P<0.05)。结论经维生素C抗氧化治疗血清SOD水平可接近正常水平,但危重HF患者与SOD相关微量元素代谢明显紊乱,尚需根据CHF与IHF不同特征补充微量元素。
Objective To investigate the changes of superoxide dismutase (SOD) and its related microelements during and after hyperemia and ischemic heart failure (HF), and to provide basis for the treatment of trace elements in HF patients. Methods Serum SOD levels were measured by radioimmunoassay in 27 emergency HF patients before and after vitamin C treatment. The contents of trace elements Cu, Zn, Se and Fe in plasma and erythrocytes were measured by Hitachi 180-80 atomic absorption spectrophotometer. Results There was no significant difference in SOD between congestive HF (CHF) and ischemic heart disease with ischemic HF (IHF) and both. The levels of Se, Fe and Cu in erythrocytes before and after CHF were significantly different from those in normal group (P <0.01). The levels of Zn and Cu in plasma before and after treatment were significantly lower than those in normal group (P <0.01). Before treatment, plasma Se was significantly lower than normal group (P <0.05). The levels of Se, Fe and Cu in erythrocytes in IHF before and after treatment were significantly lower than those in normal group (P <0.01). The levels of Cu and Zn in plasma before and after IHF were significantly lower than those in normal group (P <0.01). After IHF erythrocyte treatment, Cu increased and Zn decreased (P <0.05). Plasma IHC before IHF was lower than that of CHF group (P <0.05). Conclusions The level of serum SOD may be close to the normal level by anti-oxidant vitamin C treatment. However, the metabolism of trace elements related to SOD in critically ill HF patients is obviously disturbed. Trace elements should be supplemented according to the different characteristics of CHF and IHF.