老年脑梗死患者高同型半胱氨酸血症和氧化应激及炎性反应的关系研究

目的探讨老年脑梗死患者高同型半胱氨酸(Hcy)血症和氧化应激及炎性反应之间的关系及颈动脉粥样硬化的发病机制。方法有颈动脉狭窄的动脉粥样硬化相关性老年脑梗死患者72例(脑梗死组),其中轻度狭窄33例,中度狭窄24例,重度狭窄15例;另选健康体检者38例(对照组)。对2组血浆Hcy、血清超氧化物歧化酶(S()D)、丙二醛、单核细胞趋化蛋白1(MCP-1)、白细胞介素8(IL-8)进行检测,分析其变化规律及其相关性。结果脑梗死组患者Hcy、丙二醛、MCP-1和IL-8含量明显高于对照组,而SOD明显低于对照组(P<0.01);轻、中、重度狭窄患者Hcy、丙二醛、MCP 1和IL 8含量随颈动脉狭窄程度加重,呈逐渐升高的趋势,而SOD呈逐渐降低(P<0.01)。脑梗死组血浆Hcy水平与SOD、丙二醛、MCP-1和IL-8含量有相关性;丙二醛含量与MCP-1和IL-8含量有相关性。结论老年脑梗死患者高Hcy血症和氧化应激及炎性反应之间是一种复杂的相互作用关系,高Hcy血症介导氧化应激和炎性反应机制参与了颈动脉粥样硬化的发生和发展。

Relationship of hyperhomocysteinemia with inflammatory reaction and oxidative stress in elderly patients with cerebral infarction

Objective To investigate the relationship of hyperhomocysteinemia with oxidative stress and inflammatory reaction in elderly patients with cerebral infarction and the pathogenesis of carotid artery atherosclerosis.Methods Seventy-two elderly patients with cerebral infarction combined with carotid artery stenosis were included in the study.The light stenosis was seen in 33 cases,middle stenosis in 24 cases,and heavy stenosis in 15 cases.Thirty-eight healthy people were adopted as control group.The levels of plasma homocysteine were determined by high performance liquid chromatography method.The levels of serum SOD and MDA were detected by xanthine oxidase method and thiobarbituric acid reactive substance respectively.The levels of serum MCP-1 and IL-8 were determined by ELISA.Results Levels of Hcy,MDA,MCP-1 and IL-8 in the cerebral infarction group were significantly higher than those in the control group,while level of SOD in the cerebral infarction group was lower than that in the control group.Levels of Hcy, MDA,MCP-1 and IL-8 in the patients with light stenosis,middle stenosis and heavy stenosis increased while level of SOD decreased with progression of carotid artery stenosis.Hcy was correlated with SOD,MDA,MCP-1 and IL-8,MDA was correlated with MCP-1 and IL-8.Conclusion The relationship of hyperhomocysteinemia with oxidative stress and inflammatory reaction in elderly patients with cerebral infarction was complex interaction.The mechanism of oxidative stress and inflammatory reaction was mediated by hyperhomocysteinemia,which participates in occurrence and development of carotid artery atherosclerosis.