Chang C Y, Lai Y C, Cheng T J, Lau M T, Hu M L
Department of Neurology, Chi-Mei Foundation Hospital, Tainan, Taiwan, ROC.
Free Radic Res. 1998 Jan;28(1):15-24. doi: 10.3109/10715769809097872.
The possible involvement of oxidative damage and antioxidant protection has been suggested in the pathogenesis of stroke which is the second-leading cause of death in Taiwan. In this study we investigated the relationship between ischemic stroke and plasma status of antioxidants and oxidative products. Plasma levels of vitamin A, alpha-tocopherol, carotenoids, selenium (Se), total SH groups (T-SH), thiobarbituric acid-reactive substances (TBARS) and protein carbonyl, a marker of protein damage, were determined in ischemic-stroke patients (n = 36, blood sampled within 24 hrs after the clinical event) in comparison with 21 matched controls. The cholesterol-adjusted carotenoids and vitamin E were significantly lower (P < 0.05) in the plasma of ischemic-stroke patients than those of the controls. TBARS were higher (P < 0.05) in the patients than in the controls but Se, T-SH and protein carbonyls were not significantly different between the two groups. Separation of the patients into small-artery ischemic stroke (SAIS, n = 17) and large-artery ischemic stroke (LAIS, n = 19) groups revealed that both carotenoids/cholesterol and vitamin E/cholesterol ratios were significantly lower in both LAIS and SAIS groups than the controls (n = 21) while vitamin A/cholesterol was not different among the three groups. TBARS were only significantly higher in the LAIS group. The results demonstrated that, within 24 hrs after the clinical event, the acute-ischemic stroke patients had lowered levels of cholesterol-adjusted carotenoids and alpha-tocopherol but elevated levels of TBARS in the plasma as compared to the matched controls. It remains to be resolved as to whether enhanced lipid peroxidation is a cause or a result of lowered antioxidants in ischemic stroke.
氧化损伤和抗氧化保护作用可能参与了中风的发病机制，中风是台湾地区第二大死因。在本研究中，我们调查了缺血性中风与抗氧化剂及氧化产物血浆状态之间的关系。测定了缺血性中风患者（n = 36，临床事件发生后24小时内采血）与21名匹配对照者血浆中维生素A、α-生育酚、类胡萝卜素、硒（Se）、总巯基（T-SH）、硫代巴比妥酸反应性物质（TBARS）以及蛋白质损伤标志物蛋白质羰基的水平。缺血性中风患者血浆中经胆固醇校正的类胡萝卜素和维生素E显著低于对照组（P < 0.05）。患者组的TBARS高于对照组（P < 0.05），但两组之间的Se、T-SH和蛋白质羰基无显著差异。将患者分为小动脉缺血性中风（SAIS，n = 17）和大动脉缺血性中风（LAIS，n = 19）组后发现，LAIS组和SAIS组的类胡萝卜素/胆固醇和维生素E/胆固醇比值均显著低于对照组（n = 21），而三组之间的维生素A/胆固醇无差异。仅LAIS组的TBARS显著升高。结果表明，在临床事件发生后24小时内，与匹配对照相比，急性缺血性中风患者血浆中经胆固醇校正的类胡萝卜素和α-生育酚水平降低，但TBARS水平升高。缺血性中风中脂质过氧化增强是抗氧化剂降低的原因还是结果，仍有待解决。
