乙醛脱氢酶2活性水平与冠心病的相关性研究

发布时间：2018-12-05 22:29

【摘要】：目的:采用双抗体一步夹心法酶联免疫吸附试验,检测急性心肌梗死组、心绞痛组和正常对照组血浆ALDH2表达水平,分析ALDH2与冠心病各组之间关系及与冠脉病变严重程度的相关性。方法:选择2015年3月至2016年10月,因胸痛、胸闷以及冠状动脉疾病其他症状发病的患者,经我院心内科医师收治于心血管内科,所入选的实验对象共217例,其中男性158例,女性82例,正常对照组共31例,包括男性19例,女性12例,平均年龄64.41±9.0岁,其中心绞痛组共82人,包括男性54例,女性28例,平均年龄63.84±9.24,急性心肌梗死组共104人,包括男性64例,女性40例,平均年龄64.72±9.62。依据冠脉病变支数及计算所得Gensini积分总和,分为若干个亚组,各亚组之间用冠脉病变支数和Gensini积分以评价冠脉病变严重程度,即根据Gensini积分分为冠脉病变轻度组,中度组,重度组,冠脉病变支数分为:单支病变、双支病变、三支病变。采用双抗体一步夹心法酶联免疫吸附实验(ELISA),用酶标仪在450nm波长测定吸光度(OD)值,计算样品ALDH2水平。结果:1急性心肌梗死组、心绞痛组、正常对照组检测ALDH2结果分别为3.44±1.53、4.08±1.85、7.32±0.34 U/L,其表达活性在AMI组最低,在正常对照组中最高,心绞痛组次之。且AMI组与正常对照组之间存在统计学差异,其P值0.05;心绞痛组与对照组同样存在统计学意义,P值0.05;但AMI与心绞痛组无统计学意义。2.ALDH2与冠脉病变支数比较结果显示:三支病变ALDH2水平高于其余两组,但冠脉病变三组之间比较,无统计学意义。3.ALDH2与冠脉病变严重程度比较结果显示:病变程度重的患者ALDH2水平最低,中度居中,轻度病变者其活性最高。4.ALDH2多重线性回归分析结果显示:冠心病高血压和HDL对ALDH2表达水平有影响,差异有统计学意义。5.冠心病包括AMI、心绞痛组与实验对象的各生化指标指标间单因素分析显示:HDL水平、ALDH2水平与患者冠心病的发病有相关性,P0.05,与其他一般指标无明显统计学意义。结论:1.ALDH2在心绞痛组、急性心肌梗死组的表达水平较正常对照组中明显降低,提示ALDH2在冠心病发病机制中起重要作用。2.ALDH2水平与冠脉病变严重程度呈负相关,有可能成为评估冠心病患者病变严重程度的的可检测指标。3.ALDH2水平与冠脉病变支数有关。4.HDL、ALDH2水平心绞痛组、急性心肌梗死组的表达水平较正常对照组中明显降低,提示HDL可能与ALDH2协同在冠心病发病机制中起重要作用。
[Abstract]:Objective: to detect the expression of plasma ALDH2 in acute myocardial infarction (AMI) group, angina pectoris group and normal control group by double antibody one step sandwich enzyme-linked immunosorbent assay (Elisa). To analyze the relationship between ALDH2 and coronary heart disease (CHD) and the relationship between ALDH2 and severity of coronary artery disease. Methods: from March 2015 to October 2016, 217 patients with chest pain, chest tightness and other symptoms of coronary artery disease were admitted to the Department of Cardiovascular Medicine, including 158 males. There were 82 females and 31 normal controls, including 19 males and 12 females, with an average age of 64.41 卤9.0 years. There were 82 patients with angina pectoris, including 54 males and 28 females, with an average age of 63.84 卤9.24 years. There were 104 patients in acute myocardial infarction group, including 64 males and 40 females with an average age of 64.72 卤9.62. According to the number of coronary lesion branches and the sum of calculated Gensini scores, they were divided into several subgroups. The severity of coronary lesions was evaluated by the number of coronary lesion branches and the Gensini score among the subgroups, that is, according to the Gensini score, they were divided into mild coronary lesion group and moderate coronary lesion group. In severe group, coronary artery lesion was divided into single vessel lesion, double vessel lesion and three vessel lesion. Double antibody one step sandwich enzyme-linked immunosorbent assay (ELISA),) was used to determine the absorbance (OD) value at 450nm wavelength and to calculate the ALDH2 level of the sample. Results: 1the results of ALDH2 in acute myocardial infarction group, angina pectoris group and normal control group were 3.44 卤1.53 卤4.08 卤1.85 卤7.32 卤0.34 U / L, respectively. The expression of ALDH2 was the lowest in AMI group, the highest in normal control group, followed by angina pectoris group. There was statistical difference between the AMI group and the normal control group (P value 0.05), and the angina pectoris group and the control group also had statistical significance (P value 0.05). However, there was no significant difference between AMI and angina pectoris. The results of 2.ALDH2 and coronary artery disease showed that the level of ALDH2 in three vessel lesions was higher than that in the other two groups, but there was a significant difference among the three groups. There was no significant difference between 3.ALDH2 and severity of coronary artery disease. The results showed that the ALDH2 level of the patients with severe lesions was the lowest, moderate, moderate. The results of 4.ALDH2 multiple linear regression analysis showed that hypertension and HDL of coronary heart disease had influence on the expression of ALDH2, and the difference was statistically significant. Univariate analysis showed that the levels of HDL and ALDH2 were correlated with the incidence of coronary heart disease in patients with coronary heart disease including AMI, angina pectoris group and experimental subjects (P 0.05), but had no statistical significance with other general indexes. Conclusion: the expression of 1.ALDH2 in angina pectoris group and acute myocardial infarction group is significantly lower than that in normal control group, suggesting that ALDH2 plays an important role in the pathogenesis of coronary heart disease. The level of 2.ALDH2 is negatively correlated with the severity of coronary artery disease. The level of 3.ALDH2 is related to the number of coronary artery disease branches. 4. The expression level of 3.ALDH2 in angina pectoris group and acute myocardial infarction group is significantly lower than that in normal control group. The results suggest that HDL and ALDH2 may play an important role in the pathogenesis of coronary heart disease.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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