急性脑梗死患者MDA、H2O2、SOD和ABTS的表达及临床意义

Activities and clinical significance of malonydialdehyde, hydrogen peroxide, superoxide dismutase and ABTS in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清丙二醛(MDA)、过氧化氢(H2O2)、超氧化物歧化酶(SOD)和抗氧化性(ABTS)的活性情况及临床意义。方法选取2017年3月至2018年8月期间西安市第九医院收治的ACI患者96例作为观察组,同时选取经影像学检查无异常的健康者96例作为对照组。根据观察组患者的不同的神经功能缺损程度,将其分为轻度脑梗死组33例、中度脑梗死组31例、重度脑梗死组32例;同时根据不同的脑梗死面积,将其分为小梗死组34例、中梗死组32例、大梗死组共30例。检测所有入组对象的血清MDA、H2O2、SOD和ABTS的活性情况。对比观察组和对照组的血清MDA、H2O2、SOD、ABTS水平,同时对比不同神经功能缺损程度以及不同脑梗死面积患者的血清MDA、H2O2、SOD、ABTS水平。结果观察组血清MDA、H2O2水平明显高于对照组,血清SOD水平和ABTS活性水平均低于对照组,差异有统计学意义(t=12.759~18.723,P <0.05);轻度组、中度组及重度组的血清MDA、H2O2、SOD、ABTS指标进行组间对比,差异有统计学意义(F=2.544~3.851,P <0.05);中度组与重度组MDA、H2O2水平高于轻度组,SOD、ABTS水平低于轻度组,比较差异有统计学意义(均P <0.05)。重度组MDA、H2O2水平高于中度组,SOD、ABTS水平低于中度组,比较差异有统计学意义(均P <0.05)。小梗死组、中梗死组及大梗死组的血清MDA、H2O2、SOD、ABTS指标进行组间对比,差异有统计学意义(F=2.675~3.597,P <0.05)。中梗死组与大梗死组MDA、H2O2水平高于小梗死组,SOD、ABTS水平低于小梗死组,比较差异有统计学意义(均P <0.05)。大梗死组MDA、H2O2水平高于中梗死组,SOD、ABTS水平低于中梗死组,比较差异有统计学意义(均P <0.05);梗死面积与急性梗死轻度(r=0.704,P <0.05)、中度(r=0.712,P <0.05)、重度(r=0.723,P <0.05)呈正相关。结论神经功能缺损程度越高的ACI患者血清MDA、H2O2水平越高,SOD、ABTS活性水平越低。在临床管理中,对ACI患者血清MDA、H2O2、SOD、ABTS水平进行检测,可有效识别患者的病情程度,对临床诊断、预后防治具有一定的临床意义。

Objective To investigate the activity and clinical significance of serum malonydialdehyde(MDA), hydrogen peroxide(H2O2), superoxide dismutase(SOD) and ABTS in patients with acute cerebral infarction(ACI). Methods 96 patients with ACI admitted to ninth hospital of Xi’an city, from March 2017 to August 2018 were selected as the observation group. At the same time, 96 healthy people with no abnormalities through imaging examination were selected as the control group. According to the degree of neurological impairment, the observation group was divided into mild cerebral infarction group(33 cases), moderate cerebral infarction group(31 cases) and severe cerebral infarction group(32 cases). Meanwhile, according to different cerebral infarction areas, the patients were divided into small infarction group(34 cases), medium infarction group(32 cases) and large infarction group(30 cases). Serum MDA, H2O2, SOD and ABTS activities were measured in all subjects. The levels of serum MDA, H2O2, SOD and ABTS were compared between the observation group and the control group. The levels of serum MDA,H2O2, SOD and ABTS were also compared in patients with different degrees of neurological impairment and different cerebral infarction areas. Results The levels of serum MDA and H2O2 in the obeservation group were significantly higher than those in the control group, and the activity levels of serum SOD and ABTS were lower than those in the control group(t=12.759~18.723, P < 0.05). The differences of serum MDA, H2O2, SOD and ABTS indexes in the mild, moderate and severe groups were statistically significant(F=2.544~3.851, P < 0.05). The levels of MDA and H2O2 in severe group and moderate group were significantly higher than those in mild group, and the levels of SOD and ABTS were lower than those in mild group(P < 0.05). The levels of SOD and ABTS in severe group were significantly higher than those in moderate group, while the levels of SOD and ABTS in severe group were lower than those in moderate group(P < 0.05). The differences of serum MDA, H2O2, SOD and ABTS in mild infarction group, middle infarction group and large infarction group were statistically significant(F=2.675~3.597, P < 0.05). The levels of MDA and H2O2 in large infarction group and middle infarction group were significantly higher than those in mild infarction group, and the levels of SOD and ABTS were significantly lower than those in mild infarction group(P < 0.05). The levels of SOD and ABTS in large infarction group were significantly higher than those in medium infarction group, while the levels of SOD and ABTS in large infarction group were lower than those in medium infarction group, and the difference was significant(P < 0.05). Correlation analysis showed that infarct size was positively correlated with mild(r=0.704, P < 0.05), moderate(r=0.712, P < 0.05) and severe acute infarction(r=0.723, P < 0.05). Conclusion The higher the degree of neurological impairment of ACI patients, the higher the levels of MDA and H2O2 are, and the lower the activity levels of SOD and ABTS are. In clinical management, the detection of serum MDA, H2O2, SOD and ABTS levels in patients with ACI can effectively identify the severity of patients, and has certain clinical significance for clinical diagnosis, prognosis prevention and treatment.