【作者】 刘兆阳；

【导师】 丁琪；

【作者基本信息】 安徽医科大学 ， 老年医学， 2009， 硕士

【摘要】 目的研究70岁以上老年人脑梗死发生后血脂、血浆氧化低密度脂蛋白（oxLDL）和8-异前列腺素F_2α(8-iso-PGF_2α)含量的改变及其与梗死灶大小、神经功能缺损评分的关系,比较在脑梗死发生后70岁以上与70岁以下老年人血浆oxLDL和8-iso-PGF_2α含量的差异,探讨氧化应激及脂质过氧化在70岁以上的老年人脑梗死发生发展过程中所起到的作用特点。以及进行抗氧化干预治疗前后,体内oxLDL和8-iso-PGF_2α含量的变化,为70岁以上老年急性脑梗死的治疗提供临床依据。方法选取急性脑梗死患者70岁以上的29例作为病例组,70岁以下30例作为内对照组;另设29名70岁以上的健康人为健康对照组,使用全自动生化分析仪检测其血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白A1（APOA1）、载脂蛋白B（APOB）、脂蛋白a[Lp（a）]、尿酸（UA）等指标,同时应用酶联免疫吸附法、分别检测血浆oxLDL和8-iso-PGF_2α水平,并进行比对和统计学分析。结果70岁以上脑梗死组及70岁以下脑梗死组血清TC、TG、LDL-C以及血浆oxLDL和8-iso-PGF_2α均高于健康对照组（P <0.05）。血浆oxLDL和8-iso-PGF_2α之间存在正相关性。70岁以上脑梗死组oxLDL、8-iso-PGF_2α水平高于70岁以下脑梗死组（P<0.05）,但是,TC、LDL-C前者则低于后者（P <0.05）。两脑梗死组血UA水平高于健康对照组（P <0.05）。但两脑梗死组之间无显著性差异（P >0.05）。结论血脂紊乱增加了脑梗死发生的风险。氧化应激及脂质过氧化水平增高,可能促进脑梗死的发生发展。与70岁以下人群相比,70岁以上老年人尽管血脂水平有所下降,但发生脑梗死后其氧化应激及脂质过氧化水平更高。抗氧化治疗可能有助于脑梗死病情的康复。更多还原

【Abstract】 ObjectiveTo detect the change of serum lipids , plasma oxidized low density lipoprotein （oxLDL） and 8 Isoprostan Prostaglandin F2alpha (8-iso-PGF_2α) after cerebral infarction in the group of the aged person who exceed 70 years old and to investigate the relationship between the level of plasma oxLDL and 8-iso-PGF_2α after cerebral infarction and the size of infarction,the NIHSS score .To compare the difference of the level of plasma oxLDL and 8-iso-PGF_2α between the group of the aged patients who exceed 70 years old and are less than 70 years old after cerebral infarction. Then to discuss the effect of oxidative stress and lipid peroxidation on the development and progression of cerebral infarction patients who exceed 70 years old.To research the change of plasma oxLDL and 8-iso-PGF_2α before and after antioxygen therapy. Then to discuss the effect of antioxygen therapy on the treatment of cerebral infarction patients who exceed 70 years old and to provide the evidence for the treatment of cerebral infarction.Methods29 patients with cerebral infarction who exceed 70 years old were chosen as case group and there were 30 patients with cerebral infarction who are less than 70 years old as internal control. In addition,another 29 healthy ages（>70 years old） as normal control. Serum total cholesterol （TC）, triglyeride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, apolipoprotein A1 （APOA1） , apolipoprotein B （APOB）, lipoprotain（a） [Lp（a）] and UA were assayed in all cases and 8-iso-PGF_2α and oxLDL were detected with ELISA in all cases.All datas were compared and analysed between groups.Results1. The concentration of TC, TG, LDL- C , oxLDL and 8-iso-PGF_2α in the case group and the internal group was higher than that of the normal group（P<0.05）.2. There is a positive correlation between the level of plasma oxLDL and 8-iso-PGF_2α.3. Compared with the group who are less than 70 years old, the concentration of 8-iso-PGF_2α and oxLDL was higher in the group who exceed 70 years old （P<0.05）, however, the concentration of TC and LDL-C was lower in the group exceed 70 years old （P<0.05）.4. Compared with the normal group,the level of serum UA was higher in both the group who exceed 70 years old and are less than 70 years old.There was no significant difference of the level of serum UA between the group who exceed 70 years old and are less than 70 years old.ConclusionThe disorder of serum lipids increases the risk of the development of cerebral infarction and the increasing of oxidative stress and lipid peroxidation promotes the initiation and progression of cerebral infarction. Compared with common adults, the level of serum lipids inclines to decrease in the group of the aged who exceed 70 years old, but the level of lipid peroxidation and oxidative stress increases after the initiation of cerebral infarction.更多还原