血清对氧磷酯酶-1及氧化低密度脂蛋白在缺血性脑卒中的临床意义

The clinical significance of serum paraoxonase-1 activity,oxidized low-density lipoprotein level in ischemic stroke

目的:探讨急性缺血性脑卒中患者血清对氧磷酯酶-1(PON-1)活性和氧化低密度脂蛋白(ox-LDL)水平的变化及其临床意义。方法:选择急性缺血性脑卒中患者96例及正常对照组72名,采用对硝基苯酚为底物的速率法和酶联免疫吸附法分别测定血清PON-1、ox-LDL,同时检测2组的总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇等生化指标并进行对比;探讨PON-1、ox-LDL与急性缺血性脑卒中的关系。结果:缺血性脑卒中组血清PON-1和高密度脂蛋白胆固醇均明显低于对照组,ox-LDL和低密度脂蛋白胆固醇明显高于对照组(P<0.01);大梗死组血清PON-1活性均低于中梗死组和小梗死组(P<0.05和P<0.01);而大梗死组ox-LDL水平均明显高于中梗死组和小梗死组(P<0.01);神经功能重度损伤组患者血清PON-1活性均明显低于轻、中度损伤组(P<0.01),而血清ox-LDL水平均显著高于轻、中度损伤组(P<0.01)。相关分析显示:PON-1与ox-LDL呈负相关关系(P<0.01)。结论:急性缺血性脑卒中患者PON-1活性降低,导致抗氧化能力减弱,使血清ox-LDL水平增加,这种改变可能是缺血性脑卒中重要的危险因素,对预测脑卒中风险有重要意义。

Objective：To investigate the changes of serum paraoxonase-1（PON-1） activity,oxidized low-density lipoprotein（ox-LDL） level in acute ischemic stroke patients and analyze the clinical significance. Methods：Ninety-six acute ischemic stroke cases and 72 health subjects were selected. Serum PON-1 activity was measured using paroxon as substrate and ox-LDL level was detected by enzyme-linked immuno sorbent assay method. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol levels were all measured in the two groups. The relationships of serum PON-1 activity,ox-LDL level and acute ischemic stroke were explored. Results：In ischemic stroke group,serum PON-1 activity and high-density lipoprotein-cholesterol level were significantly lower than those in control group（ P 〈0. 01）. Serum ox-LDL and low-density lipoprotein-cholesterol levels were significantly higher in ischemic stroke group than in control group（ P〈0. 01）. Serum PON-1 activity was significantly lower in patients with large cerebral infarction than that in patients with medium and small cerebral infarction（P〈0. 05 and P〈0. 01）. Serum ox-LDL level was significantly higher in patients with large cerebral infarction than that in patients with medium and small cerebral infarction （P〈0. 01）. Serum PON-1 activity was significantly lower in patients with severe neurologic impairment than that in patients with mild and moderate neurologic impairment （P〈0. 01）. Serum ox-LDL level was significantly higher in the patients with severe neurologic impairment than that in the patients with mild and moderate neurologic impairment（P〈0. 01）. Based on the correlation analysis,PON-1 activity was correlated negatively with ox-LDL（P〈0. 01）. Conclusions：In the patients with acute ischemic stroke,serum PON-1 activity was decreased and ox-LDL level was increased, the changes may be an important risk factor for ischemic stroke. It has an important meaning to forecast the risk of ischemic stroke.