急性缺血性脑血管病患者TXB2、6-keto-PGF1α、oxLDL和Lp(a)水平分析

Analysis of plasma TXB2,6-keto-PGF1α,Ox LDL and Lp( a) levels in the patients with acute ischemic cerebrovascular disease

目的观察急性缺血性脑血管病患者血浆血栓素B2(TXB2)、6-酮-前列环素1α(6-keto-PGF1α,6-k)及TXB2/6-ketoPGF1α比值(T/6-k)、氧化型低密度脂蛋白(ox LDL)和脂蛋白(a)[LP(a)]水平,为临床积极干预提供参考依据。方法纳入急性短暂性脑缺血发作患者(TIA)70例,急性脑梗死患者(AIS)80例,健康对照者(NC)120例;用ELISA双抗体夹心法测定ox LDL、Lp(a)、TXB2,用ELISA竞争抑制法测定6-k;分别测定TIA和AIS患者发病24 h、7 d、14 d时的血浆TXB2、6-k及T/6-k、ox LDL和Lp(a),将3个时间状态值与健康人对照组进行统计分析。结果 TIA组和AIS组,发病24 h、7 d、14 d的血浆ox LDL、Lp(a)、TXB2及6-k水平均高于健康人对照组(P均<0.01)。TIA组和AIS组患者发病24 h、7 d、14 d相互比较:TXB2水平发病24 h、7 d时差异均无统计学意义(P均>0.05),发病14 d时TXB2比较差异有统计学意义(P<0.01);6-k水平比较差异均无统计学意义(P均>0.05);T/6-k水平发病7 d、14 d比较差异均有统计学意义(P均<0.05);ox LDL水平比较差异均无统计学意义(P均>0.05);Lp(a)水平比较差异均无统计学意义(P均>0.05)。结论 TXB2、6-k、ox LDL和Lp(a)检测对于TIA患者积极预防进一步发展为脑梗死有重要的警示价值,且对于防止AIS患者再次发作,积极进行二级预防有重要意义。

Objective To detect plasma thromboxane B2 （TXB2）, 6-keto-prostacyclin FloL （6-keto-PGF1α, 6-k）, the ratio of TXB2/6-k （T/6-k）, oxidized low density lipoprotein （oxLDL） and lipoprotein （a） [ Lp（a） ] levels in the patients with acute ische- mic cerebrovascular disease, and provide evidence for clinical intervention. Methods Plasma samples from 70 patients with acute transient ischemic attack （TIA）, 80 with acute ischemic stroke （AIS） and 120 healthy controls （NC） were collected, and the levels of oxLDL, Lp（a） and TXB2 were determined by double antibody sandwich ELISA, and 6-k level by competitive inhibition ELISA. For the patients with TIA or AIS, plasma TXB2, 6-k, T/6-k, oxLDL and Lp（a） levels were detected 24 hours, 1 week and 2 weeks after symptom onset, respectively. Then, the obtained results from the patients and healthy controls were compared and analyzed. Results All the levels of plasma oxLDL, Lp（ a）, TXB2 and 6-k 24 hours, 1 week and 2 weeks after onset in both TIA and AIS patients were significantly higher than that in healthy controls （P 〈0.01 ）. The levels of plasma TXB2 24 hours and 1 week after onset in TIA and AIS patients were significantly higher than that 2 weeks after onset （P 〈0.01 ）, while there was no significant difference between the former （ P 〉 0.05 ）. The level of plasma 6-k 24 hours after onset was significantly lower than those 1 week and 2 weeks after onset for TIA and AIS patients （P 〈 0.01 ）. There was significant difference in the ratio of T/6-k between 1 week and 2 weeks after onset in TIA and AIS patients （P 〈 0.05）. However, there was no any significant difference in plasma oxLDL and Lp（a） levels among 24 hours, 1 week and 2 weeks after onset in TIA and AIS patients （ P 〉 0.05 ）. Conclusion The determination of plasma TXB2, 6-k, oxLDL and Lp（a） levels may play an important role in early warning and prevention of AIS.