缺血性脑卒中特征性不饱和脂肪酸的分析

Analysis of characteristic unsaturated fatty acids in ischemic stroke

目的分析缺血性脑卒中的特征性不饱和脂肪酸的特点.方法根据病程将71例缺血性脑卒中患者(卒中组)分为急性缺血性脑卒中亚组(急性亚组)40例及慢性缺血性脑卒中亚组(慢性亚组)31例,并纳入同期住院的非脑卒中患者93例为对照组.采用液相色谱串联质谱法检测患者的不饱和脂肪酸,包括十六碳一烯酸(C_(16:1))、十八碳一烯酸(C_(18:1))、十八碳二烯酸(C_(18:2))、α-十八碳三烯酸(α-C_(18:3))、γ-十八碳三烯酸(γ-C_(18:3))、二十碳一烯酸(C_(20:1))、二十碳四烯酸(C_(20:4))、二十碳五烯酸(C_(20:5))、ω-3-二十二碳五烯酸(ω-3-C_(22:5))、ω-6-二十二碳五烯酸(ω-6-C_(22:5))、二十二碳六烯酸(C_(22:6)).计算ω-6族(C_(18:2),γ-C_(18:3),C_(20:4),ω-6-C_(22:5))与ω-3族(α-C_(18:3),ω-3-C_(22:5),C_(20:5),C_(22:6))的比值.结果与对照组比较,卒中组及急性亚组血清C_(18:2)水平显著降低(Z=-1.990,Z=-2.559;均P<0.05),其余不饱和脂肪酸水平及ω-6/ω-3差异无统计学意义(均P>0.05),慢性亚组各不饱和脂肪酸水平及ω-6/ω-3差异均无统计学意义(均P>0.05).与慢性亚组比较比较,急性亚组ω-6-C_(22:5)与C_(22:6)水平显著降低(Z=-2.064,Z=-2.603;均P<0.05),其余不饱和脂肪酸水平及ω-6/ω-3差异无统计学意义(均P>0.05).以6为截断值时,卒中组与对照组、急性亚组与对照组、慢性亚组与对照组ω-6/ω-3差异有统计学意义(χ^(2)=26.484,P<0.05;χ^(2)=25.140,P<0.05;χ^(2)=25.655,P<0.05),急性亚组与慢性亚组ω-6/ω-3差异无统计学意义(χ^(2)=0.006,P=0.938).以10为截断值时,急性亚组与对照组ω-6/ω-3差异有统计学意义(χ^(2)=3.973,P<0.05),卒中组与对照组、急性亚组与慢性亚组、慢性亚组与对照组差异无统计学意义(χ^(2)=2.719,P=0.099;χ^(2)=1.046,P=0.306;χ^(2)=0.318,P=0.573).结论缺血性脑卒中患者发生C_(18:2)、C_(22:6)、ω-6/ω-3为主的特征性改变,检测不饱和脂肪酸有助于缺血性脑卒中的早期干预治疗.

Objective To analyze the characteristic unsaturated fatty acids of ischemic stroke.Methods According to the course of the disease,71 patients with ischemic stroke(stroke group)were divided into acute ischemic stroke subgroup(acute subgroup,40 patients)and chronic ischemic stroke subgroup(chronic subgroup,31 patients),and 93 non-stroke patients hospitalized during the same period were included as control group.Unsaturated fatty acids were detected by tandem liquid chromatography,including hexadecenoic acid(C_(16∶1)),octadarenoic acid(C_(18:1)),linoleic acid(C_(18:2)),α-linolenic acid(α-C_(18:3)),γ-linolenic acid(γ-C_(18:3)),eicenocarmonenoic acid(C_(20:1)),eicosatetraenoic acid(C_(20:4)),eicosapentaenoic acid(C_(20:5)),ω-3-docosapentaenoic acid(ω-3-C_(22:5)),ω-6-dodecocarpentaenoic acid(ω-6-C_(22:5))and docosahexaenoic acid(C_(22:6)).The ratios of group-6(C_(18:2),γ-C_(18:3),C_(20:4),ω-6-C_(22:5))to group-3(α-C_(18:3),ω-3-C_(22:5),C_(20:5),C_(22:6))were calculated.Results Compared with those in the control group,serum C_(18:2) levels were significantly reduced in the stroke group and acute subgroup(Z=-1.990,Z=-2.559;all P<0.05),no significant differences in remaining unsaturated fatty acid levels andω-6/ω-3(all P>0.05),and no significant differences in unsaturated fatty acid levels andω-6/ω-3 in chronic subgroups(all P>0.05).Compared with those in the chronic subgroup,the levels ofω-6-C_(22:5) and C_(22:6) were significantly reduced in the acute subgroup(Z=-2.064,Z=-2.603;all P<0.05),with no significant differences in the remaining unsaturated fatty acid levels andω-6/ω-3(all P>0.05).When 6 was used as the cutoff value,the difference in theω-6/ω-3 between the stroke group and the control group,the acute subgroup and the control group,and the chronic subgroup and the control group were statistically significant(χ^(2)=26.484,P<0.05;χ^(2)=25.140,P<0.05;χ^(2)=25.655,P<0.05);there was no significant difference inω-6/ω-3 between the acute subgroup and the chronic subgroup(χ^(2)=0.006,P=0.938).When 10 was used as the cut-off value,the difference ofω-6/ω-3 between the acute subgroup and the control group was statistically significant(χ^(2)=3.973,P<0.05);there was no significant difference inω-6/ω-3 between the stroke group and the control group,the acute subgroup and the chronic subgroup,and the chronic subgroup and the control group(χ^(2)=2.719,P=0.099;χ^(2)=1.046,P=0.306;χ^(2)=0.318,P=0.573).Conclusions The main charac-teristic changes of C_(18:2),C_(22:6) andω-6/ω-3 were found in patients with ischemic stroke.Detection of unsaturated fatty acids is helpful for early intervention treatment of ischemic stroke.