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目的:探讨颈动脉粥样硬化斑块患者血浆一氧化氮(NO)及诱导型一氧化氮合酶(iNOS)含量的变化及其临床意义。方法:选择60例经CT或彩色多普勒超声诊断仪证实的颈动脉粥样硬化症患者,采用放射免疫法、硝酸还原酶法及分光光度法进行血浆ET、N0及iNOS水平检测。结果:按超声结果动脉粥样硬化(AS)病变程度分为:Ⅰ期14例,Ⅱ期23例,Ⅲ期26例,Ⅰ、Ⅱ、Ⅲ期ET、iNOS水平显著高于对照组(P均<0.01),NO含量显著低于对照组(P均<0.01)。三组间比较,Ⅲ期ET、iNOS水平显著高于Ⅰ期、Ⅱ期(P均<0.01);NO含量显著低于Ⅰ期、Ⅱ期(P均<0.01),而Ⅱ期NO、iNOS及ET水平与I期比较亦有高度显著性差异(P均<0.01)。与无斑块组比较,有斑块组ET、iNOS明显增高,NO明显降低(P<0.01);与稳定斑块组比较,易损斑块组ET、iNOS明显增高,NO明显降低(P<0.01)。结论:血清NO、iNOS在颈动脉粥样硬化患者中有明显变化,iNOS处于高水平,而N0处于低水平,NO、iNOS水平与患者病变程度和斑块稳定性相关。
Objective: To investigate the changes of plasma nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in patients with carotid atherosclerotic plaque and its clinical significance. Methods: Sixty patients with carotid atherosclerosis confirmed by CT or color Doppler echocardiography were selected for detection of plasma ET, N0 and iNOS levels by radioimmunoassay, nitrate reductase and spectrophotometry. Results: According to the results of ultrasound, the degree of atherosclerosis (AS) was divided into: stage Ⅰ in 14 cases, stage Ⅱ in 23 cases and stage Ⅲ in 26 cases. The levels of ET and iNOS in stage Ⅰ, Ⅱ and Ⅲ were significantly higher than those in control group (P <0.01), NO content was significantly lower than the control group (P <0.01). The levels of ET and iNOS in stage Ⅲ were significantly higher than those in stage Ⅰ and Ⅱ (all P <0.01); the levels of NO in stage Ⅲ were significantly lower than those in stage Ⅰ and Ⅱ (all P <0.01) There was also a highly significant difference between ET levels and stage I (all P <0.01). The levels of ET and iNOS in plaque group were significantly higher than those in non-plaque group (P <0.01). Compared with stable plaque group, ET and iNOS in vulnerable plaque group were significantly increased (P < 0.01). CONCLUSIONS: Serum NO and iNOS have significant changes in patients with carotid atherosclerosis, iNOS is at a high level and N0 is at a low level. The levels of NO and iNOS are correlated with the degree of lesion and plaque stability.