同型半胱氨酸对急性缺血性脑卒中严重程度的影响：氨基硫醇氧化还原状态的可能作用。
Impact of homocysteine on acute ischemic stroke severity: possible role of aminothiols redox status.
机构信息
The School of Medicine, Nankai University, 94# Weijin Road, Tianjin, 300071, China.
Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China.
出版信息
BMC Neurol. 2024 May 24;24(1):175. doi: 10.1186/s12883-024-03681-5.
BACKGROUND
Acute ischemic stroke (AIS) is one of the most common cerebrovascular diseases which accompanied by a disruption of aminothiols homeostasis. To explore the relationship of aminothiols with neurologic impairment severity, we investigated four aminothiols, homocysteine (Hcy), cysteine (Cys), cysteinylglycine (CG) and glutathione (GSH) in plasma and its influence on ischemic stroke severity in AIS patients.
METHODS
A total of 150 clinical samples from AIS patients were selected for our study. The concentrations of free reduced Hcy (Hcy), own oxidized Hcy (HHcy), free reduced Cys (Cys), own oxidized Cys (cysteine, Cyss), free reduced CG (CG) and free reduced GSH (GSH) were measured by our previously developed hollow fiber centrifugal ultrafiltration (HFCF-UF) method coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The concentration ratio of Hcy to HHcy (Hcy/HHcy), Cys to Cyss (Cys/Cyss) were also calculated. The neurologic impairment severity of AIS was evaluated using National Institutes of Health Stroke Scale (NIHSS). The Spearman correlation coefficient and logistic regression analysis was used to estimate and perform the correlation between Hcy, HHcy, Cys, Cyss, CG, GSH, Hcy/HHcy, Cys/Cyss and total Hcy with NIHSS score.
RESULTS
The reduced Hcy and Hcy/HHcy was both negatively correlated with NIHSS score in AIS patients with P = 0.008, r=-0.215 and P = 0.002, r=-0.249, respectively. There was no significant correlation of Cys, CG, GSH, HHcy, Cyss, Cys/Cyss and total Hcy with NIHSS score in AIS patients with P value > 0.05.
CONCLUSIONS
The reduced Hcy and Hcy/HHcy, not total Hcy concentration should be used to evaluate neurologic impairment severity of AIS patient.
背景
急性缺血性脑卒中（AIS）是最常见的脑血管疾病之一，伴有含硫氨基酸（aminothiols）稳态的破坏。为了探讨含硫氨基酸与神经功能缺损严重程度的关系，我们研究了血浆中的四种含硫氨基酸，即同型半胱氨酸（Hcy）、半胱氨酸（Cys）、半胱氨酰甘氨酸（CG）和谷胱甘肽（GSH），以及它们在 AIS 患者中对缺血性脑卒中严重程度的影响。
方法
本研究共选取了 150 例 AIS 患者的临床样本。采用我们之前开发的中空纤维离心超滤（Hollow Fiber Centrifugal Ultrafiltration，HFCF-UF）法结合高效液相色谱-串联质谱（High Performance Liquid Chromatography-Tandem Mass Spectrometry，HPLC-MS/MS）测定游离还原型 Hcy（Hcy）、自身氧化型 Hcy（HHcy）、游离还原型 Cys（Cys）、自身氧化型 Cys（胱氨酸，Cyss）、游离还原型 CG（CG）和游离还原型 GSH（GSH）的浓度。还计算了 Hcy 与 HHcy 的浓度比（Hcy/HHcy）和 Cys 与 Cyss 的浓度比（Cys/Cyss）。采用国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评估 AIS 患者的神经功能缺损严重程度。采用 Spearman 相关系数和逻辑回归分析评估 Hcy、HHcy、Cys、Cyss、CG、GSH、Hcy/HHcy、Cys/Cyss 和总 Hcy 与 NIHSS 评分之间的相关性。
结果
在 AIS 患者中，还原型 Hcy 和 Hcy/HHcy 均与 NIHSS 评分呈负相关（P=0.008，r=-0.215；P=0.002，r=-0.249）。在 AIS 患者中，Cys、CG、GSH、HHcy、Cyss、Cys/Cyss 和总 Hcy 与 NIHSS 评分之间无显著相关性（P 值均大于 0.05）。
结论
还原型 Hcy 和 Hcy/HHcy 而不是总 Hcy 浓度可用于评估 AIS 患者的神经功能缺损严重程度。
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