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目的:探讨血浆非对称二甲基精氨酸(ADMA)浓度与急性冠状动脉综合征(ACS)及其不同亚组之间的相关性。方法:根据临床病情,并结合冠状动脉造影结果,将ACS组(88例)患者分为不稳定型心绞痛(UAP)亚组(56例)和急性心肌梗死(AMI)亚组(32例);对照组(42例)为冠状动脉正常患者。通过高效液相色谱联合质谱法(HPLC)测定血浆ADMA、L-精氨酸(L-Arg)含量,比色法测定HDL-C、TC、TG和尿酸(UA)。结果:ACS组血浆ADMA浓度显著高于对照组[(5.18±1.32)∶(3.70±1.32)μg/L,P<0.01],血浆L-Arg/ADMA浓度比低于对照组(1.64±0.60∶2.49±1.79,P<0.01),血浆L-Arg浓度在2组间差异无统计学意义。亚组间分析:AMI亚组血浆ADMA浓度显著高于对照组[(5.60±1.46)∶(3.70±1.32)μg/L,P<0.01]和UAP亚组[(5.60±1.46)∶(4.93±1.22)μg/L,P<0.05],血浆L-Arg/ADMA浓度比值低于对照组[(1.57±0.79)∶(2.49±1.79),P<0.01];UAP亚组血浆ADMA浓度高于对照组[(4.93±1.22)∶(3.70±1.32)μg/L,P<0.01],L-Arg/ADMA浓度比值低于对照组[(1.67±0.45)∶(2.49±1.79),P<0.01];血浆L-Arg浓度在3组间差异无统计学意义。血浆ADMA与HDL-C、TC、TG、UA浓度无相关性。结论:ACS患者血浆ADMA浓度显著升高,血浆L-Arg/ADMA浓度比值显著降低,ADMA浓度升高是ACS的危险因素,且独立于冠心病传统危险因子。
Objective: To investigate the relationship between plasma asymmetric dimethylarginine (ADMA) concentration and acute coronary syndrome (ACS) and its different subgroups. Methods: The ACS group (88 cases) were divided into unstable angina pectoris (UAP) subgroup (56 cases) and acute myocardial infarction (AMI) subgroup (32 cases) according to clinical conditions and coronary angiography. Control group (42 cases) were normal coronary artery patients. Plasma ADMA and L-arginine (L-Arg) contents were determined by HPLC and mass spectrometry. HDL-C, TC, TG and uric acid (UA) were determined by colorimetry. Results: The concentration of plasma ADMA in ACS group was significantly higher than that in control group [(5.18 ± 1.32) vs (3.70 ± 1.32) μg / L, P <0.01], and the plasma L-Arg / 2.49 ± 1.79, P <0.01). There was no significant difference in plasma L-Arg concentration between the two groups. Subgroup analysis: The ADMA concentration in AMI subgroup was significantly higher than that in control group [(5.60 ± 1.46) vs (3.70 ± 1.32) μg / L, P <0.01] and UAP subgroup [(5.60 ± 1.46) vs 1.22) μg / L, P <0.05]. The plasma concentration of L-Arg / ADMA was lower than that of the control group [(1.57 ± 0.79) :( 2.49 ± 1.79, P <0.01] (4.93 ± 1.22) vs (3.70 ± 1.32) μg / L, P <0.01], and the ratio of L-Arg / ADMA was lower than that of the control group (1.67 ± 0.45 vs 2.49 ± 1.79, P <0.01) There was no significant difference in plasma L-Arg concentration among the three groups. There was no correlation between plasma ADMA and HDL-C, TC, TG and UA concentrations. Conclusion: The plasma ADMA concentration in patients with ACS is significantly increased, and the plasma L-Arg / ADMA concentration ratio is significantly lower. The ADMA concentration is a risk factor for ACS and is independent of the traditional risk factors of coronary heart disease.