血清对氧磷酯酶1活性和氧化低密度脂蛋白水平与急性脑梗死进展及复发的相关性

Relation among serum paraoxonase-1 activity,oxidized low density lipoprotein level,progression and recrudescence of acute cerebral infarction

目的探讨血清对氧磷酯酶1(PON-1)活性和氧化低密度脂蛋白(ox-LDL)水平与急性脑梗死进展与复发的关系。方法选取2011年5月至2013年10月于河北省唐山市协和医院神经内科住院的急性脑梗死患者96例(脑梗死组),根据入院时病情分为首发组(45例)和复发组(51例),入院后依据病情变化分为进展组(38例)和非进展组(58例);同期选择门诊健康体检者72例作为正常对照组。采用对硝基苯酚为底物的速率法和酶联免疫吸附试验法分别测定血清PON-1活性和ox-LDL浓度,同时检测血脂生化指标。结果脑梗死组血清PON-1、高密度脂蛋白胆固醇明显低于正常对照组[(152±40)U/L比(194±37)U/L、(1.3±0.4)mmol/L比(1.6±0.6)mmol/L],ox-LDL、低密度脂蛋白胆固醇明显高于正常对照组[(545±131)μg/L比(402±71)μg/L、(3.5±0.6)mmol/L比(3.2±0.8)mmol/L],差异有统计学意义(均P<0.05)。复发组PON-1明显低于首发组,ox-LDL明显高于首发组[(130±28)U/L比(171±39)U/L、(588±134)μg/L比(507±116)μg/L],差异均有统计学意义(均P<0.05)。进展组PON-1明显低于非进展组,ox-LDL明显高于非进展组[(124±24)U/L比(170±38)U/L、(596±143)μg/L比(512±111)μg/L],差异均有统计学意义(均P<0.05)。Pearson相关分析结果显示,脑梗死急性期血清PON-1活性与ox-LDL浓度呈明显负相关(r=-0.582,P<0.001)。结论血清PON-1活性、ox-LDL水平与脑梗死有密切关系,可能是急性脑梗死发生、进展及复发的重要危险因素。

Objective To investigate the relation among serum paraoxonase-1(PON-1)activity,oxidized low density lipoprotein(ox-LDL)level,progression and recrudescence of acute cerebral infarction(ACI).Methods Ninety-six ACI patients admitted to Tangshan Union Medical Hospital,Hebei Province from May 2011 to October 2013 were enrolled.According to the diagnosis on admission,the patients were divided into initial ACI group(45 cases)and recurrent ACI group(51 cases).According to the development of disease during hospitalization,the patients were divided into progression group(38 cases)and non-progression group(58 cases).Seventy-two healthy people were enrolled as control group.Serum PON-1 activity was tested by rate method using p-nitrophenol as substrate.Serum ox-LDL concentration was tested by enzyme linked immunosorbent assay.Biochemical indexes of blood lipids were detected.Results Serum PON-1 and high-density lipoprotein cholesterol in ACI patients were significantly lower than those in control group[(152±40)U/L vs(194±37)U/L,(1.3±0.4)mmol/L vs(1.6±0.6)mmol/L];serum ox-LDL and low-density lipoprotein cholesterol in ACI patients were significantly higher than those in control group[(545±131)μg/L vs(402±71)μg/L,(3.5±0.6)mmol/L vs(3.2±0.8)mmol/L](all P<0.05).Serum PON-1 in recurrent ACI group was significantly lower and ox-LDL was higher than those in initial ACI group[(130±28)U/L vs(171±39)U/L,(588±134)μg/L vs(507±116)μg/L](both P<0.05).Serum PON-1 in progression group was significantly lower and ox-LDL was higher than those in non-progression group[(124±24)U/L vs(170±38)U/L,(596±143)μg/L vs(512±111)μg/L](both P<0.05).Pearson test showed that serum PON-1 activity was negatively correlated with ox-LDL concentration in ACI patients(r=-0.582,P<0.001).Conclusion Serum PON-1 and ox-LDL are important risk factors of the occurrence,progression and recrudescence of ACI.