急性缺血性脑卒中患者外周血氧化三甲胺的相关性研究

Relationship between trimethylamine N-oxide in peripheral blood of acute ICS patients

目的探讨两种不同病因类型的急性缺血性脑卒中患者外周血三甲基胺N-氧化物(TMAO)和人连蛋白(Zonulin)水平的关系。方法选择温州医科大学附属东阳市人民医院急性缺血性脑卒中患者108例(脑卒中组),脑卒中组根据两种不同病因类型又分为大动脉粥样硬化(LAA)组85例和心源性栓塞(CE)组23例。另选择我院健康体检者59例(对照组)。比较3组Zonulin、TMAO、白细胞计数和血脂水平及其与急性缺血性脑卒中的相关性。结果与对照组比较,LAA组白细胞计数和载脂蛋白(apo)B水平明显升高,apoA-Ⅰ、apoA-Ⅰ/apoB、HDL-C水平明显降低,CE组LDL-C水平明显降低(P<0.05,P<0.01)。与对照组比较,LAA组和CE组TMAO、Zonulin水平明显升高(P<0.05,P<0.01)。年龄均衡后脑卒中组TMAO水平明显高于对照组[(2763.0±408.7)μg/L vs(1642.0±144.1)μg/L,P<0.01]。LAA组TMAO水平与颈动脉斑块面积呈正相关(r=0.333,P=0.009)。结论在急性缺血性脑卒中患者中,外周血TMAO、Zonulin在LAA、CE发病机制中发挥着重要的作用。

Objective To study the relationship between TMAO and zonulin in peripheral blood of acute ischemic cerebral stroke(ICS)patients with two different etiological types.Methods One hundred and eight acute ICS patients served a stoke group.The patients in stroke group were fur-ther divided into LAA group(n=85)and CE group(n=23)with 59 people who underwent phys-ical examination in our hospital during the same period served as a control group.Their serum levels of zonulin,TMAO,blood lipids were measured and WBC were calculated.The relationship of serum zonulin,TMAO,blood lipids levels and WBC count with acute ICS was analyzed.Results The WBC count and serum apoB level were significantly higher while the serum apoA-Ⅰ,apoA-Ⅰ/apoB and HDL-C levels were significantly lower in LAA group than in control group and the ser-um LDL-C level was significantly lower in CE group than in control group(P<0.05,P<0.01).The serum TMAO and zonulin levels were significantly higher in LAA group and CE group than in control group(P<0.05,P<0.01).The serum TMAO level was significantly higher in stroke group than in control group after age equalization(2763.0±408.7μg/L vs 1642.0±144.1μg/L,P<0.01).Correlation analysis showed that serum TMAO level was positively related with carot-id plaque size in LAA group(r=0.333,P=0.009).Conclusion TMAO and zonulin in peripheral blood play an important role in pathogenesis of LAA and CE in acute ICS patients.