脑卒中患者血清中氧化应激指标的检测及临床意义

Determination and clinical significance of serum oxidative stress indicators in patients with cerebral stroke

目的探讨脑卒中患者血清中氧化应激指标水平的变化及其临床意义。方法采用酶联免疫吸附试验（ELISA）测定168例脑卒中患者[其中缺血性脑卒中（IS）86例、出血性脑卒中（ICH）82例]和93名健康体检者（正常对照组）血清8-羟基脱氧鸟苷酸（8-OHd G）、丙二醛（MDA）和谷胱甘肽过氧化物酶（GSH-Px）。结果 IS和ICH组血清8-OHd G水平{中位数（M）[四分位数间距（P25～P75）]}分别为17.4（8.3～32.1）、9.3（6.6～21.8）ng/m L,MDA水平[M（P25～P75）]分别为5.6（4.4～11.2）、7.2（5.5～13.0）ng/m L,均明显高于正常对照组[4.3（2.1～6.9）、2.5（1.1～4.5）ng/m L]（P均〈0.05）;GSH-Px水平[M（P25～P75）]分别为479.5（259.2～861.7）、277.3（128.6～379.6）ng/m L,明显低于正常对照组[751.2（567.2～904.7）ng/m L]（P〈0.05）。IS组血清8-OHd G及GSH-Px水平明显高于ICH组（P〈0.05）,而MDA水平2个组之间差异无统计学意义（P〉0.05）。脑卒中患者8-OHd G与MDA、GSH-Px呈正相关（r值分别为0.21、0.59,P〈0.01）,GSH-Px与MDA无相关性（r=0.11,P〉0.05）。结论血清8-OHd G、MDA和GSH-Px是脑卒中患者发生氧化应激的灵敏指标。8-OHd G、GSH-Px水平与脑卒中病情密切相关,对脑卒中患者的鉴别诊断具有重要价值。

Objective To investigate the change and clinical significance of serum oxidative stress indicators in patients with cerebral stroke. Methods Serum 8-hydroxydeoxyguanosine （ 8-OHdG ） , malondialdehyde （ MDA ） and glutathione peroxidase （ GSH-Px ） in 168 patients with cerebral stroke, including 86 patients with ischemic stroke （ IS ） and 82 patients with intracerebral hemorrhage （ ICH ） , and 93 healthy subjects （ healthy control group） were determined by enzyme-linked immunosorbent assay （ELISA）. Results Serum 8-OHdG levels {median （M） [quartile interval （P25-P75）]} in IS and ICH groups were 17.4 （8.3-32.1） and 9.3 （6.6- 21.8） ng/mL, and MDA levels [M （P25-P75） ] were 5.6 （4.4-11.2） and 7.2 （ 5.5-13.0 ） ng/mL, which were significantly higher than those in healthy control group [4.3 （ 2.1-6.9 ） and 2.5 （ 1.1-4.5 ） ng/mL] （P〈0.05） , while serum GSH-Px levels [M （P25-P75） ] were 479.5 （ 259.2-861.7 ） and 277.3 （ 128.6-379.6 ） ng/mL, which were significantly lower than those in healthy control group [751.2 （ 567.2-904.7 ） ng/mL] （P〈0.05） . The levels of 8-OHdG and GSH-Px were higher in IS group than in ICH group （/＇〈0.05 ） , and MDA levels had no statistical significance between the 2 groups （ P〉0.05 ） . The 8-OHdG levels in patients with cerebral stroke were positively correlated with MDA and GSH-Px （ r=0.21 and 0.59, P〈0.01 ） , and the GSH-Px level had no correlation with MDA level （r=0.11, P〉0.05 ） . Conclusions The levels of serum 8-OHdG, MDA and GSH-Px are sensitive oxidative stress indicators for patients with cerebral stroke. The levels of serum 8-OHdG and GSH-Px correlate with the severity of cerebral stroke, which are significant in the differential diagnosis of cerebral stroke.