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Objective To explore the changes of glutathione and nicotinamide adenine dinucleotide phosphate levels and their significances among elderly patients with acute myocardial infarction,elderly patients with angina pectoris and elderly people with normal coronary artery.Methods Totally 64 elderly patients with acute myocardial infarction were selected according to the clinical manifestation,electrocardiogram and myocardial markers.68 elderly patients with angina pectoris and 66 subjects with normal coronary artery (control group) were enrolled according to the coronary artery radiography.Peripheral venous blood in all subjects were taken and plasma glutathione (reduced form GSH and oxidized form GSSG) and nicotinamide adenine dinucleotide phosphate (reduced form NADPH and oxidized form NADP+) were measured.The GSH/GSSG ratio and NADPH/NADP+ redox potentials were calculated according to Nernst equation.Results Compared with control group,GSH level in acute myocardial infarction group and angina pectoris group significantly increased(4.04 ± 0.77 μmol/L,5.89 ± 0.85 μmol/L,7.55 ± 0.93 μmol/L; P＜0.05 or 0.01),GSSG decreased(0.70±0.05 μmol/L,0.61±0.04 μmol/L,0.53±0.03 μmol/L;P＜0.05 or 0.01),GSH/GSSG ratio increased(5.18±1.06,9.76±1.67,12.80±1.93; P＜0.05 or 0.01).The GSH/GSSG redox potentials decreased(-123.49 ± 1.18 mV,-126.21 ± 1.01mV,-128.71 ±1.29 mV;P＜0.05 or 0.01).Compared with control group,NADPH in acute myocardial infarction group increased(5.72 ± 0.44 nmol/L,6.83± 0.55 nmol/L ; P＜0.05),NADPH/NADP ratio increased (2.29±0.10,2.58±0.26,P＜0.05),the NADPH/NADP+ redox potentials significantly decreased (-306.3±2.44 mV,-312.1±2.53 mV; P＜0.05).Conclusions The imbalance of plasma redox status migrating to oxidization may have close relationships with atheromatous plaque formation,plaque rupture and thrombosis.
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Objective To explore the changes and clinical significance of plasma redox status in patients with acute myocardial infarction,angina pectoris and people with normal coronary artery.Methods According to the clinical manifestation,electrocardiograms and the myocardium markers,68 acute myocardial infarction patients (group A) were involved.68 angina pectoris patients (group B) and 68 normal coronary artery people (group C) were also chosen according to the coronary artery radiographs.Peripheral venous blood of 3 groups were collected.Plasma glutathione (reduced form GSH and oxidized form GSSG) and nicotinamide adenine dinucleotide phosphate (reduced form NADPH and oxidized form NADP+) were detected.The GSH/GSSG and NADPH/NADP+ redox potentials were calculated according to Nernst equation.Results Along with the pathological aggravation of coronary artery (from group C to group A),the levels of GSH [(8.39±1.03)μmol/L,(6.54±0.94) μmol/L,(4.49±0.86) μmol/L,respectively] and GSH/GSSG (14.22±2.14,9.76±1.67,5.76±1.18,respectively) were gradually reduced; the levels of GSSG [(0.59±0.03) μmol/L,(0.67±0.04) μmol/L,(0.78 ± 0.05) μmol/L,respectively] and GSH/GSSG redox potential [(-150.43±3.43) mV,(-141.22±3.12) mV,(-135.21±2.31) mV,respectively] were gradually increased (all P＜ 0.05); the changes of NADPH/NADP+ redox status were similar to GSH/GSSG but milder.Conclusions The imbalance of plasma redox status deviating to oxidation has a relationship with atheromatous plaque formation,plaque rupture and plaque thrombosis in the coronary artery.
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Objective To observe the clinical efficacy of ezetimibe combined with atorvastatin calcium on hyperlipidemia,and to evaluate the role of ezetimibe on lipid management in elderly patients with coronary heart disease (CHD) after coronary intervention.Methods A total of 150 elderly CHD patients with hyperlipidemia to undergo coronary intervention in our hospital were selected.Patients were randomly divided into the control group and the experimental group (n=75,each).Patients in control group were treated with atorvastatin,and in the experimental group with ezetimibe plus atorvastatin.The change of blood lipids levels and the incidence of adverse reactions were compared between the two groups 1 month after the treatment.Results The numbers of patients with normal serum levels of total cholesterol (TC),triglycerides (TG),low density lipoprotein (LDLC) were much more in the experimental group than in the control group after treatment [68 cases (90.7％) vs.50 cases (66.7％),62 cases (82.7％) vs.44 cases (58.7％),56 cases (74.7％) vs.38 cases (50.7％),x2 =12.87,10.42,9.23,respectively,all P＜0.01].There was no significant difference in the incidence of adverse reactions between the two groups [5.3％ (4 case) vs.2.7％ (2 cases),x2 =0.17,P ＞ 0.05].Conclusions Compared with atorvastatin calcium treatment,ezetimibe combined with atorvastatin calcium treatment has a better clinical efficacy on hyperlipidemia with no increase of adverse reactions in elderly CHD patients.
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ObjectiveTo evaluate the efficacy and safety of spironolactone in treatment NYHA (New York Heart Association) class Ⅰ - Ⅱ heart failure patients. MethodsEighty eight patients with NYHA classⅠ- Ⅱheart failure were randomized to sprionolactone or placebo groups.Patients were assessed by echocardiography and 6-minute walking test (6MWT) ,plasma aldosterone and NT-proBNP were measured before and 6 months after treatment; serum potassium and creatinine were monitored through the study. ResultsThe E/A and E/E' in spironolactone group were significantly lower than those of control group (1.2±0.7 vs. 1.7±0.6, P=0.007;15.2±2.3vs. 17.7±3.0, P=0.000). No differences were observed in left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)between two groups after treatment. Left ventricular mass index (LVMI) in spironolactone group decreased after theatment [(117 ±27) g/m2 vs.(112 ± 19) g/m2,P = 0.044]. Plasma aldosterone level in spironolactone group after treatment was significantly lower than that of control group [ ( 157 ± 16) ng/L vs.( 165 ± 16) ng/L, P =0. 021 ]. Although there were no differences in plasma NT-proBNP level between two groups after treatment, it decreased significantly comparing with that of before treatment ( P = 0. 000). No differences were observed in serum potassium and creatinine between two groups after treatment. However serum potassium and creatinine in spironolactone group increased significantly after treatment [ ( 83 ± 18 )pmol/Lvs. (87 ± 22) μmol/L, P =0.047; (4.4 ±0.4) mmoL/L vs. (4.5 ±0.6) mmol/L, P =0. 012]. ConclusionSpironolactone can alleviate cardiac remolding and diastolic function in NYHA classⅠ - Ⅱ heart failure patients.
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Objective To explore the changes of plasma redox status in patients with coronary heart disease and its clinical implications. Methods One hundred and forty-four patients suspected with coronary heart disease were divided into three groups according to the results of coronary arteriography. Coronary heart disease group (n= 59, group A), coronary atherosclerosis group (n=53, group B), and normal coronary group (n=32, group C). The plasma glutathione (reduced form GSH and oxidized form GSSG) ,oxidized low density hpoprotein cholesterol(ox-LDL-C) and malondialdehyde (MDA) were measured in all patients. The GSH/GSSG redox potential were calculat-ed according to Nernst equation,and their correlation with the severity of coronary artery stenosis and oxLDL-C was analyzed. Results Along with the severity of coronary artery stenosis (from Group C to Group A), GSH, GSH/ GSSG gradually reduced (respectively (321.27±56.80)μmol/L, (309.52±44.97) μmol/L, ( 285.71±38.38) μmol/L;10.56±1.70,9.86±1.58,8.65±1.18 ;F=29.49 and 26.18,P<0.05), whereas GSH/GSSG redox po-tential gradually increased ( (- 142.23±1.35) mV, (-140.41±1.13) mV, (-136.61±1.21 ) mV;F =20.69,P <0.05 )) and redox status deviated to oxidization. The products of oxidative stress oxLDL-C and MDA also increased significantly along with the severity of coronary artery stenosis (respectively (417.24±126.64 ) μg/L, (557.45±171.85) μg/L, (691.96±203, 56 ) μg/L;(2.39±1.24) μmol/L, (3.25±1.37 ) μmol/L, (4.39± 1.52) μmol/L;F=26.28 and 25.39,P<0.05). GSH/GSSG redox potential was positively correlated with oxLDL-C (r=0.798,P<0.05). Conclusions The imbalance of plasma redox status and deviating to oxidization may be closely related with the development and progress of atherosclerosis.
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OBJECTIVE: To explore the effects of Xuezhikang Capsules (ZXKC) and probucol on blood lipids, vascular endothelial functions and redox status in patients with coronary heart disease. METHODS: One hundred and twelve patients with coronary heart disease were randomly divided into XZKC-treated group and probucol-treated group, 56 in each. Before and after 8-week treatment, the blood levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), nitric oxide (NO), endothelin-1 (ET-1), reduced glutathione (GSH) and oxidized glutathione (GSSG) were all measured in both groups. The GSH/GSSG redox potential (Eh) was calculated according to the Nernst equation. RESULTS: In the XZKC-treated group, the blood levels of TC, LDL-C and TG were significantly decreased after 8-week treatment as compared with those before treatment. The blood levels of TC and LDL-C were also significantly decreased in the probucol-treated group as compared with those before treatment. In the XZKC-treated group, the blood levels of ET-1 and GSSG and the GSH/GSSG Eh after treatment were all significantly lower than those before treatment, whereas the blood levels of GSH and NO, the NO/ET-1 ratio, and the GSH/GSSG ratio after treatment were all significantly higher than those before treatment. CONCLUSION: The XZKC or probucol treatment can yield a significant decrease in blood lipids in patients with coronary heart disease. Furthermore, XZKC exerts effective protection on vascular endothelial function, and can make GSH/GSSG redox status shift towards deoxidation.