陈琦玲,王鸿懿,孙宁玲

• 1:北京大学人民医院心脏中心

摘要(Abstract)：

目的探讨高血压及伴冠心病的动脉粥样硬化患者血浆同型半胱氨酸(Hcy)、一氧化氮(NO)变化的特性。方法对高血压或伴冠心病患者通过颈动脉超声及冠状动脉造影明确存在动脉粥样硬化的患者211例,冠心病/高血压病患者99例,高血压122例,进行Hcy、NO及超敏C反应蛋白(hs-CRP)测定。结果冠心病患者血浆Hcy浓度为(18.57±7.47)μmol/L,明显高于单纯高血压组(14.53±10.58)μmol/L(P<0.01),hs-CRP水平(3.73±3.89)mg/L,明显高于高血压组(2.38±2.86)mg/L,P<0.05。冠心病患者血清NO浓度为(51.15±18.78)μmol/L,显著低于高血压组(70.39±41.55)μmol/L,P<0.001。结论 Hcy、NO及hs-CRP的异常与动脉粥样硬化的发展有关,冠心病冠状动脉粥样硬化伴颈动脉粥样硬化多部位血管病变患者的Hcy与NO水平反比的程度以及hs-CRP明显高于高血压伴颈动脉病变的单部位的患者,提示Hcy水平及炎症参与了血管损伤的过程。

关键词(KeyWords)： 冠心病;高血压;动脉粥样硬化,同型半胱氨酸;一氧化氮

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈琦玲,王鸿懿,孙宁玲

参考文献(References)：

• [1]陈灏珠.动脉粥样硬化实用内科学[M].第10版.北京:人民卫生出版社,1997:1218-1225.
• [2]Tanaka H,Nishino M,Ishida-M,et al.Progression of carotid atherosclerosis in Japanese patients wiht coronary artery disease[J].Stroke,1992,23(7):946-951.
• [3]Oleary DH,Polak JF,K ronmal RA,et al.Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study[J].Stroke,1992,23(12):1752-1760.
• [4]Zeng X,DAi J,Remick DG,et al.Homocysteine mediated expression and secretion of monocyte chemoattractant protein-1and interleukm-8 in human monocytes[J].Circ Res,2003,93(4):311-320.
• [5]Zhang Q,Zeng X,Guo J,et al.Effects of homocysteine on murine splenic B lymphocyte proliferation and its signal transduction mechanism[J].Cardiovasc Res,2001,52(2):328-336.
• [6]Zhang Q,Zeng X,Guo J,et al.Oxidant stress mechanism of homocysteine potentiating Con A-induced proliferation in murine splenic T lymphocytes[J].Cardiovasc Res,2002,53(4):1035-1042.
• [7]Wang G,Dai J,Mao J,et al.Folic acid reverses hyper-responsiveness of LPS-induced chemokine secretion from monocytes in paitients with hyperhomocysteinemia[J].Atherosclerosis,2005,179(2):395-402.
• [8]张宝娓,汪波,姚兴海,等.动脉粥样硬化家兔主动脉壁与红细胞L2精氨酸/一氧化氮系统变化[J].中华心血管病杂志,2002,30(5):302-304.
• [9]Ortolani P,Marzocehi A,Marrozzini C,et al.Clinical relevance of homocysteine levels in patients receiving coronary stenting for unstable angina[J].Ital Heart J,2004,5(3):189-196.
• [10]Zhang D,Fang P,Jiang X,et al.Severe hyperhomocysteinemia promotes bone marrow-derived and resident inflammatory monocyte differentiation and atherosclerosis in LDLr/CBSdeficient mice[J].Circ Res,2012,111(1):37-49.