氧化低密度脂蛋白和一氧化氮的相互作用及其在缺血性脑卒中发病中的作用

Interaction of plasma oxidized low density lipoprotein with nitric oxide in pathogenesis of ischemic stroke

目的研究急性缺血性脑卒中患者血浆氧化低密度脂蛋白（ｏｘＬＤＬ）与一氧化氮（ＮＯ）的关系及它们在缺血性脑卒中发病机制中的作用。方法测定４５名健康体检者、２０例动脉硬化患者和７５例急性缺血性脑卒中患者血浆ＬＤＬ及体外氧化获得的ｏｘＬＤＬ对血小板聚集功能和ＮＯ水平的影响。结果动脉硬化和脑卒中患者血浆ｏｘＬＤＬ值均明显升高，提示血浆ＬＤＬ及ｏｘＬＤＬ对血小板聚集有明显的促进作用，同时降低ＮＯ水平；血小板聚集的增强和ｏｘＬＤＬ呈正相关，和ＮＯ呈负相关，而和ＬＤＬ水平无相关性。结论脑卒中和动脉硬化患者ＬＤＬ对氧化修饰的易感性增加，氧化修饰的ＬＤＬ通过激活血小板、灭活ＮＯ而促进动脉粥样硬化，易致血栓形成。因此，抗氧化治疗在脑卒中和动脉硬化的防治中有重要意义。

Objective To investigate the interaction of plasm oxidized low density lipoproptein (oxLDL) with nitric oxide(NO) in pathogenesis of ischemic stroke. Method The effect of plasma LDL and oxidize modified LDL in vitro in 45 healthy controls, 20 patients with atherosclerosis and 75 patients with acute ischemic stroke on platelet aggregation and NO level was determined. Results The plasma LDL and oxLDL of patients significantly enhanced platelet aggregation and decreased the level of NO simultaneously.The increase in platelet aggregation was related to the concentrations of plasma oxLDL positively and to the levels of NO negatively. But no relation between platelet aggregation and plasma LDL. Conclusion The LDL of patients with atherosclerosis and ischemic stroke is more susceptible to oxidative modification and the oxidized LDL can activate platelet and inactivate NO.These activities may promote atherosclerotic thrombosis and development of ischemic stroke.