脑梗死患者同型半胱氨酸及氧化、抗氧化指标的测定及其意义

目的探讨血清总同型半胱氨酸(HCY)与急性脑梗死发病的关系及可能致病机制.方法脑梗死组40例、健康对照组30名采用荧光偏振免疫分析法测定血清HCY和分光光度比色分析法测定血浆一氧化氮(P-NO)、血浆维生素C(P-VitC)、血浆过氧化脂质(P-LPO)及红细胞超氧化物歧化酶(E-SOD)水平.结果脑梗死组HCY、P-NO、P-LPO均高于对照组(P＜0.01),而P-VitC、E-SOD均低于对照组(P＜0.01).HCY与P-VitC呈负相关(r=-0.51,P＜0.01),HCY与P-LPO、P-NO呈正相关(r分别为0.51、0.52,均P＜0.01);P-VitC与P-LPO呈负相关(r=-0.58,P＜0.01);E-SOD与P-NO呈负相关(r=-0.85,P＜0.01).结论高HCY血症与脑梗死发病有关,氧化应激损伤可能是其致病机制之一.

Measurement of homocysteine,oxidative and antioxidative indexes in patients with acute cerebral infarction

Objective To investigate the status of oxidant stress in the acute phase of cerebral infarction and the possible role of plasma homocysteine. Methods Blood samples were collected in 40 patients with cerebral infarction (CIG) within 3 days of onset and 30 normal subjects (CG). The serum homocysteine concentrations were measured by fluorescence polarization immunoassay. Plasma nitric oxide (P-NO) , ascorbic acid (P-VitC), lipid peroxide (P-LPO) and erythrocyte superoxide dismutase (E-SOD) were measured by spectrophotometric assay. Results Statistically significant elevation of homocysteine (P<0.01), lipid peroxide (P<0.01), and nitric oxide (P<0.01) levels were observed in CIG compared with CG. On the other hand, the antioxidant ascorbic acid plasma levels were significantly lower in CIG compared with CG (P<0.01). The study also revealed a significant and positive correlation between homocysteine and lipid peroxide (r=0.51, P<0.01). Homocysteine concentrations were also significantly positively correlated with nitric oxide (r=0.52, P<0.01). The ascorbic acid level was negatively correlated with lipid peroxide(r=-0.58, P<0.01). The nitric oxide level was negatively correlated with superoxide dismutase(r=-0.83, P<0.01). Conclusion Hyperhomocysteinemia is a possible causal factor in oxidative stress during the acute phase of CI. Pharmacological intervention could potentially be beneficial in this setting and warrants further evaluation.