脑梗死并高脂血症患者血浆P-选择素水平的变化及降脂干预

为研究动脉粥样硬化性脑梗死患者动脉粥样硬化病变的炎症反应以及降脂干预对其产生的影响 ,以酶标多克隆抗体夹心法及硝酸还原酶比色法测定 36例健康对照组、30例急性脑梗死并高胆固醇血症组及 2 8例急性脑梗死并高甘油三酯血症组患者应用辛伐他汀治疗前后血浆P 选择素、氧化型低密度脂蛋白和血清一氧化氮的水平。结果发现 ,两组脑梗死患者血浆P 选择素和氧化型低密度脂蛋白水平较对照组明显增高 ,血清一氧化氮水平明显减低。急性脑梗死并高胆固醇血症组患者的血浆P 选择素水平与血浆氧化型低密度脂蛋白和低密度脂蛋白水平呈显著正相关 ,与血清一氧化氮水平呈显著负相关 ;急性脑梗死并高甘油三酯血症组患者的血浆P 选择素水平与氧化型低密度脂蛋白和甘油三酯水平呈显著正相关。辛伐他汀治疗 6周后 ,两组脑梗死患者的血浆P 选择素和氧化型低密度脂蛋白水平明显减低 ,血清一氧化氮水平明显回升。以上提示 ,急性脑梗死并高胆固醇血症和高甘油三酯血症患者均存在着动脉粥样硬化病变的炎症反应 ,其炎症反应的发展与血浆P 选择素水平的变化及血浆氧化型低密度脂蛋白、低密度脂蛋白、甘油三酯和血清一氧化氮水平的变化相一致 ,降脂干预可阻止动脉粥样硬化病变炎症反应的发展

Study of Levels of Plasma P-Selectin and Interventions of Lipid-Lowering in the Patients of Cerebral Infarction with Hyperlipidemia

Aim To study the inflammatory reaction in the arteriosclerotic lesions and effect of it by interventions of lipid lowering in the patients of Acute cerebral infarction(ACI)with hyperlipidemia. Methods To measure the level of soluble plasma P selectin and oxidized low density lipoprotein (ox LDL) by ELISA and serum nitric oxide (NO) by colorimetric analysis method before and after treatment with simvastatin in 30 patients of ACI with hypercholesterolemia(HC group), 28 patients of ACI with hypertriglyceridemia(HTG group) and 36 normal controls. Results The patients with ACI of HC group and HTG group had higher levels of plasma P selectin and ox LDL, lower level of serum NO than control group. A direct positive correlation was observed in P selectin level with ox LDL, LDLC and ox LDL, TG in HC group and HTG group separately. A direct negative correlation was found between plasma P selectin and NO levels in patients of HC group. After administration of simvastatin (20 mg/d for 6 weeks) to patients of HC group and HTG group, plasma P selectin and ox LDL levels reduced significantly and serum NO level elevated significantly. Conclusions The inflammatory reaction in the arteriosclerotic lesions exists both in the patients of ACI with hypercholesterolemia and hypertriglyceridemia, the development of it is synchronized with the levels of plasma P selectin, ox LDL,TG and serum NO, which can be blocked by intervention of lipid lowering.