脑梗死患者血清Hcy水平与氧化应激、炎症和胰岛素抵抗状态的相关性研究(1)
【摘要】 目的：揭示脑梗死患者血清Hcy水平与氧化应激、炎症和胰岛素抵抗状态的相关关系。方法：检测所有入选者血清Hcy、MDA、SOD、hs-CRP、sICAM-1、FPG、FINS和HOMA-IR各指标的含量，揭示脑梗死患者的血清Hcy水平与机体氧化应激、炎症及胰岛素抵抗状态的相关关系。
结果：高血压合并脑梗死组血清Hcy水平显著高于单纯高血压组和正常对照组(P<0.05);高血压合并脑梗死组MDA、hs-CRP、sICAM-1、FPG、FINS和HOMA-IR水平均显著高于单纯高血压组和正常对照组(P<0.05)，而SOD含量则较正常对照组明显降低(P<0.05);高血压合并脑梗死组血清Hcy含量与MDA、SOD、hs-CRP、sICAM-1和HOMA-IR水平分别进行相关分析表明，Hcy与MDA、hs-CRP、sICAM-1和HOMA-IR均呈正相关，但Hcy与SOD则呈负相关。结论：血清Hcy水平的升高是脑梗死发生发展的重要风险因素之一，氧化应激、炎症反应和胰岛素抵抗均在脑梗死中起重要作用，Hcy水平升高可能是导致氧化应激、炎症和胰岛素抵抗产生的一种因素。
【关键词】 脑梗死; 同型半胱氨酸; 氧化应激; 炎症; 胰岛素抵抗
Relationship between Elevated Serum Hcy Level and Oxidative Stress，Inflammation and Insulin Resistance Status in Cerebral Infarction Patients/LIANG Yaru，LI Qiguang，CHEN Peisong，et al.//Medical Innovation of China，2019，16(21)：00-006
【Abstract】 Objective：To reveal the correlation between oxidative stress，inflammation，insulin resistance and elevated serum Hcy levels in cerebral infarction patients.Method：By detecting serum Hcy，MDA，SOD，hs-CRP，sICAM-1，FPG，FINS and HOMA-IR levels of all the candidates，we intended to reveal the relationship between oxidative stress，inflammation，insulin resistance and Hcy levels of patients with cerebral infarction.Result：Hcy level in hypertension complicated with cerebral infarction group was significantly higher than those of single hypertension group and normal control group(P<0.05).MDA，hs-CRP，sICAM-1，FPG，FINS and HOMA-IR levels in hypertension complicated with cerebral infarction group were significantly higher than those of single hypertension group and normal control group(P<0.05)，but SOD level was significantly lower in hypertension complicated with cerebral infarction group(P<0.05).Moreover，Hcy and MDA，hs-CRP，sICAM-1 and HOMA-IR were respectively positively correlated，but it was a negative correlation relationship between Hcy and SOD in hypertension complicated with cerebral infarction group.Conclusion：Hhcy is one of the important risk factors in occurrence and development of cerebral infarction，oxidative stress，inflammation and insulin resistance play important roles in cerebral infarction，and Hhcy may cause oxidative stress，inflammation and insulin resistance.
【Key words】 Cerebral infarction; Homocysteine; Oxidative stress; Inflammation; Insulin resistance
First-author’s address：The Sixth Affiliated Hospital of Guangzhou Medical University，Qingyuan 511518，China
doi：10.3969/j.issn.1674-4985.2019.21.001
中風是目前严重危害人类健康的脑血管疾病，由于其具有发病率高、致残率高及致死率高的特点，成为我国医疗健康资源的重大负担[1]。其中缺血性中风又称为脑梗死，占中风比例的80%～85%[2]，是由于各种因素导致局部脑组织区域血液供应障碍，使脑组织缺氧、坏死，继而引发神经功能的减退、缺失症状。随着生活水平的提高，脑梗死的发病率也有上升趋势，因此发现新的独立危险因素、研究脑梗死的致病机制是非常重要的。研究报道，HHcy与颅内动脉钙化和AS形成紧密相关[3]，AS是导致心脑血管疾病的重要因素，是脑梗死的病理基础，氧化应激-炎症贯穿AS斑块的形成和发展过程中[4-5]。另外有研究表明，以高胰岛素血症为主要标志的IR和脑梗死的发生有关[6]，但其之间的具体机制尚不清楚。因此本研究通过对高血压合并脑梗死患者、单纯高血压患者及体检健康人员血清Hcy水平及氧化应激和炎症指标的检测分析，意在探讨脑梗死患者血液Hcy水平与氧化应激和炎症的关系，为研究脑梗死的病因学提供更多线索。现报道如下。, http://www.100md.com(梁雅茹 李齐光 陈培松 冯品宁 李介华)
结果：高血压合并脑梗死组血清Hcy水平显著高于单纯高血压组和正常对照组(P<0.05);高血压合并脑梗死组MDA、hs-CRP、sICAM-1、FPG、FINS和HOMA-IR水平均显著高于单纯高血压组和正常对照组(P<0.05)，而SOD含量则较正常对照组明显降低(P<0.05);高血压合并脑梗死组血清Hcy含量与MDA、SOD、hs-CRP、sICAM-1和HOMA-IR水平分别进行相关分析表明，Hcy与MDA、hs-CRP、sICAM-1和HOMA-IR均呈正相关，但Hcy与SOD则呈负相关。结论：血清Hcy水平的升高是脑梗死发生发展的重要风险因素之一，氧化应激、炎症反应和胰岛素抵抗均在脑梗死中起重要作用，Hcy水平升高可能是导致氧化应激、炎症和胰岛素抵抗产生的一种因素。
【关键词】 脑梗死; 同型半胱氨酸; 氧化应激; 炎症; 胰岛素抵抗
Relationship between Elevated Serum Hcy Level and Oxidative Stress，Inflammation and Insulin Resistance Status in Cerebral Infarction Patients/LIANG Yaru，LI Qiguang，CHEN Peisong，et al.//Medical Innovation of China，2019，16(21)：00-006
【Abstract】 Objective：To reveal the correlation between oxidative stress，inflammation，insulin resistance and elevated serum Hcy levels in cerebral infarction patients.Method：By detecting serum Hcy，MDA，SOD，hs-CRP，sICAM-1，FPG，FINS and HOMA-IR levels of all the candidates，we intended to reveal the relationship between oxidative stress，inflammation，insulin resistance and Hcy levels of patients with cerebral infarction.Result：Hcy level in hypertension complicated with cerebral infarction group was significantly higher than those of single hypertension group and normal control group(P<0.05).MDA，hs-CRP，sICAM-1，FPG，FINS and HOMA-IR levels in hypertension complicated with cerebral infarction group were significantly higher than those of single hypertension group and normal control group(P<0.05)，but SOD level was significantly lower in hypertension complicated with cerebral infarction group(P<0.05).Moreover，Hcy and MDA，hs-CRP，sICAM-1 and HOMA-IR were respectively positively correlated，but it was a negative correlation relationship between Hcy and SOD in hypertension complicated with cerebral infarction group.Conclusion：Hhcy is one of the important risk factors in occurrence and development of cerebral infarction，oxidative stress，inflammation and insulin resistance play important roles in cerebral infarction，and Hhcy may cause oxidative stress，inflammation and insulin resistance.
【Key words】 Cerebral infarction; Homocysteine; Oxidative stress; Inflammation; Insulin resistance
First-author’s address：The Sixth Affiliated Hospital of Guangzhou Medical University，Qingyuan 511518，China
doi：10.3969/j.issn.1674-4985.2019.21.001
中風是目前严重危害人类健康的脑血管疾病，由于其具有发病率高、致残率高及致死率高的特点，成为我国医疗健康资源的重大负担[1]。其中缺血性中风又称为脑梗死，占中风比例的80%～85%[2]，是由于各种因素导致局部脑组织区域血液供应障碍，使脑组织缺氧、坏死，继而引发神经功能的减退、缺失症状。随着生活水平的提高，脑梗死的发病率也有上升趋势，因此发现新的独立危险因素、研究脑梗死的致病机制是非常重要的。研究报道，HHcy与颅内动脉钙化和AS形成紧密相关[3]，AS是导致心脑血管疾病的重要因素，是脑梗死的病理基础，氧化应激-炎症贯穿AS斑块的形成和发展过程中[4-5]。另外有研究表明，以高胰岛素血症为主要标志的IR和脑梗死的发生有关[6]，但其之间的具体机制尚不清楚。因此本研究通过对高血压合并脑梗死患者、单纯高血压患者及体检健康人员血清Hcy水平及氧化应激和炎症指标的检测分析，意在探讨脑梗死患者血液Hcy水平与氧化应激和炎症的关系，为研究脑梗死的病因学提供更多线索。现报道如下。, http://www.100md.com(梁雅茹 李齐光 陈培松 冯品宁 李介华)