Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Stroke. 2011 Aug;42(8):2326-9. doi: 10.1161/STROKEAHA.111.618835. Epub 2011 Jun 23.
We investigated changes in oxidative damage after ischemic stroke using multiple biomarkers.
Serial blood and urine samples of ischemic stroke subjects and age-matched control subjects were assayed for F₂-isoprostanes, hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, 24-hydroxycholesterol, allantoin, and urate.
Sixty-six stroke subjects (mean age, 65 years; median National Institutes of Health Stroke Scale 17) and 132 control subjects were recruited. A bimodal pattern of change was observed in plasma and urinary F₂-isoprostanes and plasma 24-hydroxycholesterol. The rise in plasma hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, and allantoin was highest 6 to 12 hours after stroke onset, whereas plasma urate was significantly lower than controls on Days 1 to 3. After adjusting for age and baseline National Institutes of Health Stroke Scale, baseline plasma esterified hydroxyeicosatetraenoic acid products (OR, 1.01; 95% CI, 1.01 to 1.02), plasma urate (1.01; 1.00 to 1.01), and plasma free F₄-neuroprostanes (2.73; 1.76 to 3.93) were associated with 90-day good functional recovery (modified Rankin Scale ≤1).
Multiple markers of oxidative damage are increased immediately after stroke and remain elevated for several days. Recognition of these temporal changes may help design better antioxidant treatment trials for acute ischemic stroke.
我们使用多种生物标志物研究了缺血性脑卒中后氧化损伤的变化。
对缺血性脑卒中患者和年龄匹配的对照者的连续血样和尿样进行 F₂-异前列腺素、羟二十碳四烯酸产物、F₄-神经前列腺素、24-羟胆固醇、尿囊素和尿酸的测定。
共纳入 66 例脑卒中患者（平均年龄 65 岁，美国国立卫生研究院卒中量表中位数为 17）和 132 例对照者。我们观察到血浆和尿液 F₂-异前列腺素及血浆 24-羟胆固醇呈双峰式变化。脑卒中发作后 6 至 12 小时，血浆羟二十碳四烯酸产物、F₄-神经前列腺素和尿囊素升高幅度最大，而第 1 至 3 天血浆尿酸明显低于对照组。校正年龄和基线美国国立卫生研究院卒中量表后，基线血浆酯化羟二十碳四烯酸产物（比值比，1.01；95%置信区间，1.01 至 1.02）、血浆尿酸（1.01；1.00 至 1.01）和血浆游离 F₄-神经前列腺素（2.73；1.76 至 3.93）与 90 天良好功能恢复（改良 Rankin 量表≤1）相关。
缺血性脑卒中后即刻多种氧化损伤标志物增加，并持续升高数天。认识这些时间变化可能有助于设计更好的急性缺血性脑卒中抗氧化治疗试验。
