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急诊科急性卒中患者氧化应激和抗氧化水平的研究。

Investigation of oxidant and antioxidant levels in patients with acute stroke in the emergency service.

作者信息

Atik İsmail, Kozacı Nalan, Beydilli İnan, Avcı Mustafa, Ellidağ Hamit, Keşaplı Mustafa

机构信息

Department of Emergency Medicine, Ümraniye Education and Research Hospital, İstanbul, Turkey.

Department of Emergency Medicine, Antalya Education and Research Hospital, Antalya, Turkey.

出版信息

Am J Emerg Med. 2016 Dec;34(12):2379-2383. doi: 10.1016/j.ajem.2016.08.062. Epub 2016 Aug 30.

Abstract

OBJECTIVE

In this study, we aimed to identify oxidative stress and the disruption in the oxidant-antioxidant balance in the acute phase of stroke and, therefore, to detect markers that will guide in the diagnosis and treatment of stroke.

MATERIALS AND METHODS

Eighty-six patients who were admitted to Antalya Training and Research Hospital Emergency Department between June 2013 and December 2013 and who were diagnosed as having stroke were enrolled in this study. The control group consisted of 40 healthy volunteers. Blood samples collected from all participants were screened for albumin, ischemic modified albumin (IMA), IMA/albumin ratio (IMAR), total antioxidant status, total oxidant status (TOS), and oxidative stress index (OSI).

RESULTS

Sixty (70%) patients were diagnosed as having acute cerebral infarction (ACI) and 26 (30%) as having acute intracerebral hemorrhage (AIH). Statistically significant difference was found between AIH and control groups in terms of albumin, IMAR, TOS, OSI levels (P < .001, P < .001, P < .001, and P < .001, respectively). Statistically significant difference was found between ACI and control groups in terms of albumin, IMA, IMAR, TOS, and OSI levels (P < .001, P = .045, P < .001, P < .001, and P < .001, respectively). There was no difference between ACI patients with detected acute infarcts on cranial computed tomographic scans (n = 31) and ACI patients with normal cranial computed tomography results (n = 29) in terms of oxidant-antioxidant levels. There was a significant difference between patients admitted within 3 hours and healthy adults regarding the levels of IMAR, TOS, and OSI (P < .001, P < .001, and P < .001, respectively).

DISCUSSION AND CONCLUSION

It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore, these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.

摘要

目的

在本研究中,我们旨在确定中风急性期的氧化应激及氧化剂 - 抗氧化剂平衡的破坏情况,从而检测可指导中风诊断和治疗的标志物。

材料与方法

纳入2013年6月至2013年12月期间入住安塔利亚培训与研究医院急诊科且被诊断为中风的86例患者。对照组由40名健康志愿者组成。对所有参与者采集的血样进行白蛋白、缺血修饰白蛋白(IMA)、IMA/白蛋白比值(IMAR)、总抗氧化状态、总氧化剂状态(TOS)和氧化应激指数(OSI)的检测。

结果

60例(70%)患者被诊断为急性脑梗死(ACI),26例(30%)为急性脑出血(AIH)。AIH组与对照组在白蛋白、IMAR、TOS、OSI水平方面存在统计学显著差异(分别为P <.001、P <.001、P <.001和P <.001)。ACI组与对照组在白蛋白、IMA、IMAR、TOS和OSI水平方面存在统计学显著差异(分别为P <.001、P =.045、P <.001、P <.001和P <.001)。在头颅计算机断层扫描中检测到急性梗死灶的ACI患者(n = 31)和头颅计算机断层扫描结果正常的ACI患者(n = 29)在氧化剂 - 抗氧化剂水平方面无差异。在发病后3小时内入院的患者与健康成年人在IMAR、TOS和OSI水平方面存在显著差异(分别为P <.001、P <.001和P <.001)。

讨论与结论

可见在ACI和AIH中氧化剂 - 抗氧化剂平衡向着氧化剂方向受损。此外,在ACI的早期阶段发现了氧化剂 - 抗氧化剂平衡的损害。因此,这些生物标志物尤其可用于ACI中溶栓治疗候选者的早期诊断。

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