出血性脑中风患者红细胞胆固醇和过氧化脂质含量变化及其临床意义

目的 从脂代谢、自由基反应、氧化和脂质过氧化角度探讨诱发出血性脑中风潜在的主要危险因子。方法 采用随机对照设计，用分光光度比色分析法检测了500例脑出血急性期患(CHP)和100例健康成人志愿(HAV)的血浆胆固醇(CH)、过氧化脂质(LPO)、一氧化氮(NO)、维生素C(VC)、维生素E(VE)、β-胡萝卜素(β-CAR)含量和超氧化物歧化酶(SOD)活性及红细胞SOD、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)活性和红细胞CH、LPO含量。结果 与HAV组各生化参数(BP)平均值(AV)比较，CHP组红细胞和血浆CH，血浆VC、VE、β-CAR和SOD，红细胞SOD、CAT和GSH-Px的AV均降低，差别具有显性(P=0．0000)，而红细胞和血浆LPO、血浆NO的AV均升高，差别具有显性(P=0．0000)。对500例CHP直线及逐步回归和相关分析表明，各BP与临床神经功能缺损程度积分(NDS)和颅内出血量(IHS)均有直线相关，NDS与红细胞CH、LPO和血浆NO、VC相关最密切，IHS与红细胞CH、LPO和血浆NO、VE相关最密切。结论 显降低的红细胞CH和显升高的红细胞LPO可能是诱发出血性脑中风的潜在的主要危险因子，对脑血管疾病患进行红细胞CH和LPO的早期检测并结合患的高血压很可能有助于对脑血管疾病的诊断。

Low cholesterol level inerythrocyte membranes and high lipoperoxides level in erythrocytes may be potential mainrisk factors inducing cerebral hemorrhagic stroke in human

Objective To explore potential main risk factors inducing cerebral hemorrhagic stroke in human from lipometabolism, free radicals reactions, oxidatation and lipoperoxidation. Methods Using a random control design 500 cases of cerebral hemorrhagic patients (CHP) in the acute phase of the disease and 100 healthy adult volunteers (HAV) were investigated by means of contents of cholesterol (CH), lipoperoxides (LPO), nitric oxide (NO), vitamin C (VC), vitamin E (VE) and β － carotene (β － CAR), and activity of superoxide dismutase (SOD) in plasma as well as activities of SOD, catalase (CAT) and glutathione peroxidase (GSH－ Px) in erythrocytes (RBC), and contents of CH and LPO in RBC with spectrophotometric assays. Results Compared with the average values (AV) of every biochemical parameters (BP) in the HAV group, the AV of the CH in RBC and in plasma, and VC, VE, β － CAR and SOD in plasma as well as SOD, CAT and GSH－ Px in RBC in the CHP group were significantly decreased (P=0.0000), while the AV of the LPO in RBC and in plasma, and NO in plasma in the CHP group were significantly increased (P=0.0000). The findings of linear regression and correlation as well as stepwise regression and correlation analysis for 500 CHP showed that there was a significant linear correlation in the each BP with both clinical neurotic functional defective scales (NDS) and intracranial hemorrhagic sizes (IHS) respectively, and that the closest correlation indwelled among the NDS and the values of CH and LPO in RBC as well as NO and VC in plasma, while the closest correlation indwelled among the IHS and the values of CH and LPO in RBC as well as NO and VE in plasma. Conclusion These findings in this study suggested that marked low RBC cholesterol and marked high RBC lipoperoxides were potential main risk factors inducing cerebral hemorrhagic stroke in human. Early measurement of the values of cholesterol and lipoperoxides in RBC for cerebral vascular disease patients which connected with test of hypertension in the patients might help to diagnosis of the cerebral vascular disease.