Department of Neurology, Nevşehir State Hospital, Nevşehir, Turkey.
Department of Neurology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Turk J Med Sci. 2022 Dec;52(6):1917-1925. doi: 10.55730/1300-0144.5539. Epub 2022 Dec 21.
Acute cerebral infarction (ACI) occurs as a result of instant disruption of vascular flow that causes disbalance between oxidative/antioxidative activity. We examined the relationship of serum neuro-oxidative stress parameters with stroke severity and infarct volume in ACI and emphasized the qualitative importance of high-density lipoprotein (HDL) on its relationship with myeloperoxidase (MPO) and paraoxonase-1 (PON1) in the acute period of stroke.
One hundred ACI patients applied within the first 24 h and 50 healthy volunteers were included. The patient group was evaluated with demographic data (including arrival serum biochemical assessment), clinical disability scores, infarct volume, serum oxidative/antioxidative parameters (lipid hydroperoxide (LOOH), MPO, PON1, MPO/PON ratio). The relevant serum parameters were compared with the control group. Dysfunctional HDL measurement was based on detecting dysfunctionality as a result of a high positive correlation between the dysfunctional feature of HDL and the MPO/PON ratio. The correlation of serum parameters, clinical disability score, and infarct volume were evaluated, and independent analyses of variability with comorbidities were performed.
A negative correlation between PON1 and arrival NIH score/scale (NIHSS), LOOH and discharge modified rankin scale (mRS), triglyceride level, and infarct volume; a positive correlation between MPO\PON ratio and infarct volume was determined. Logistic regression analyses showed that hypertension, diabetes, and high HbA1C may be predictors of stroke severity, and diabetes mellitus, high HbA1C, infarct volume, and high NIHSS score may be predictors of early disability (p < 0.005). The ROC curve analysis revealed that determining the cut-off value for LOOH is of importance in determining early disability scores (7.2 and 6.2, respectively).
The balance between oxidative and antioxidative stress parameters and their quantitative/qualitative changes is of importance, especially in the acute period of ACI. Dysfunctional HDL's evolution and its relationship with other oxidants are significant not only in the cardiovascular aspect but also in the clinicoradiological aspect.
急性脑梗死（ACI）是由于血管血流突然中断而导致氧化/抗氧化活性失衡引起的。我们研究了血清神经氧化应激参数与 ACI 患者的卒中严重程度和梗死体积之间的关系，并强调高密度脂蛋白（HDL）在其与髓过氧化物酶（MPO）和对氧磷酶-1（PON1）的关系中的定性重要性，特别是在卒中的急性期。
100 例 ACI 患者在发病后 24 小时内入院，50 例健康志愿者作为对照组。对患者组进行人口统计学数据（包括入院时血清生化评估）、临床残障评分、梗死体积、血清氧化/抗氧化参数（脂质过氧化物（LOOH）、MPO、PON1、MPO/PON 比值）评估。将相关血清参数与对照组进行比较。根据 HDL 功能障碍与 MPO/PON 比值之间的高度正相关，检测 HDL 功能障碍作为功能障碍的一种方法来检测功能失调性 HDL。评估血清参数、临床残障评分和梗死体积之间的相关性，并对与共病相关的变异性进行独立分析。
PON1 与入院时 NIH 评分/量表（NIHSS）、LOOH 与出院时改良 Rankin 量表（mRS）、甘油三酯水平和梗死体积呈负相关，MPO/PON 比值与梗死体积呈正相关。逻辑回归分析显示，高血压、糖尿病和高 HbA1C 可能是卒中严重程度的预测因子，糖尿病、高 HbA1C、梗死体积和高 NIHSS 评分可能是早期残障的预测因子（p<0.005）。ROC 曲线分析显示，确定 LOOH 的截断值对早期残障评分的测定具有重要意义（分别为 7.2 和 6.2）。
氧化应激参数与抗氧化应激参数之间的平衡及其数量/质量变化很重要，特别是在 ACI 的急性期。功能失调性 HDL 的演变及其与其他氧化剂的关系不仅在心血管方面，而且在临床放射学方面都具有重要意义。
