急性动脉硬化性血栓性脑梗死患者血红素氧化酶-1活性变化的意义

Active change of heme oxygenase-1 in patients with acute atherosclerotic thrombotic cerebral infarction

目的:探讨血红素氧化酶-1(hemeoxygenase-1,HO-1)活性变化与急性动脉硬化性血栓性脑梗死(atheroscleroticthromboticcerebralinfarction,ATCI)的关系。方法:选择天津渤海石油医院神经内科住院ATCI患者68例(ATCI组),男42例,女26例,年龄65～79岁,平均(73.5±8.5)岁,对照组70例,均为本院干部体检者,男47例,女23例,年龄67～82岁,平均(73.8±9.2)岁,应用双波长分光光度法分别测定ATCI组和对照组血清HO-1活性。结果:ATCI组自发病后24h犤(59.61±12.09)nmol/(L·h)犦开始血清HO-1活性升高,于发病后第3天犤(147.11±38.44)nmol/(L·h)犦达到高峰(F=5.64,P<0.01),并一直持续到观察期末(第14天),ATCI发生后第24小时、第3天、第7天、第14天血清HO-1活性水平均显著高于对照组(t=18.656,26.041,16.965,9.473,P均<0.001),ATCI组血清HO-1活性与梗死面积(F=6.18,P<0.01)及部位(F=2.94,P<0.05)有一定关系。结论:血清HO-1活性升高与ATCI这一氧化应激的病理生理状态相关,脑缺血缺氧时HO-1表达及合成增加,其可作为反映ATCI病情发生发展的血清生化指标。

AIM: To investigate the relationship between the active changes of heme oxygenase-1(HO-1) and acute atherosclerotic thrombotic cerebral infarction (ATCI). METHODS: In ATCI group, 68 inpatients with acute ATCI were selected from the Department of Neurology, Bohai Oil Hospital of Tianjin City, including 42 male and 26 female aged 65 to 79 years old with the mean age of(73.5±8.5) years old.In control group, 70 health examinees were selected from the same hospital, including 47 male and 23 female aged 67 to 82 years old with the mean age of(73.8±9.2) years old.Double wave length spectrophotometry was used to measure the activity of serum HO-1 both in ATCI group and in control group. RESULTS: At the beginning of 24-hour episode in ATCI group, the activity of serum HO-1 was increased[(59.61±12.09) nmol/L per hour], and reached peak[(187.11±38.44) nmol/L per hour] after three-day episode(F=5.64,P< 0.01) lasting the end of the observation(the 14th day). The activity of serum HO-1 in ATCI group was significantly higher than that in control group at 24 hours, three days, seven days and 14 days after ATCI episode(t=18.656, 26.041, 16.965 and 9.473,P< 0.001). The activity of serum HO-1 was correlated to the area(F=6.18, P< 0.01)and the site(F=2.94,P< 0.05)of infarction. CONCLUSION: The increased activity of serum HO-1 is correlated to the pathophysiological oxidative stress of ATCI. The expression and synthesis of HO-1 is increased at the occurrence of cerebral ischemia and anoxia, which can be a serum biochemical scale to response the occurrence and the development of ATCI.