缺血性脑卒中患者红细胞膜磷脂组分的改变及其与红细胞流变学的关系  

Alteration of erythrocyte membrane phospholipid composition and its correlation with rheological properties of the red blood cells in ischemic stroke

作　　者：马焕文[1,2] 郭述苏[1,2] 于盛茂[1,2] 樊红 

机构地区：[1]济南军区总医院神经内科 [2]济南军区药物检验所

出　　处：《中华神经科杂志》1998年第2期102-105,共4页Chinese Journal of Neurology

摘　　要：目的探讨缺血性脑卒中患者红细胞膜磷脂各组分的改变及其对红细胞流变功能的影响。方法采用高效液相色谱法对５８例缺血性脑卒中、２３例有脑动脉硬化症状的患者和２６名健康人的红细胞膜磷脂各组分含量进行测定，并同时检测红细胞膜胆固醇含量、膜微粘度及红细胞变形能力。结果缺血性脑卒中患者红细胞膜总磷脂（ＴＰＬ）、磷脂酰胆碱（ＰＣ）、磷脂酰乙醇胺（ＰＥ）含量低于对照组；胆固醇（ＣＨＯ）、胆固醇与总磷脂比值（ＣＨＯ／ＴＰＬ比值）高于对照组；红细胞膜流动性、红细胞变形能力降低。直线相关分析，ＰＣ与红细胞膜微粘度、红细胞滤过指数呈负相关；ＰＥ与红细胞膜微粘度呈负相关；神经鞘磷脂（ＳＭ）与红细胞膜微粘度呈正相关。有脑动脉硬化症状的患者红细胞变形能力降低，膜胆固醇、胆固醇与总磷脂比值升高，但膜总磷脂及磷脂各组分无明显改变。结论缺血性脑卒中患者红细胞膜存在以ＰＣ、ＰＥ变化为主的磷脂代谢障碍，并对红细胞流变特性产生影响。Objective To study the changes of erythrocyte membrane phospholipid composition and its association with rheological characteristics of the red blood cells in ischemic stroke. Methods The erythrocyte membrane phospholipid classes,cholesterol and red blood cell rheological parameters were measured in 58 patients with ischemic stroke, 23 with arteriosclerosis and 26 normal controls. Results A decrease in erythrocyte deformability, erythrocyte membrane fluidity, total phospholipids, phosphatidylethanolamine (PE), phosphatidylcholine (PC) and an increase in cholesterol, cholesterol to total phospholipids ratios(CHO/TPL) were observed in the patients in whom significant difference was found in comparison with that of the control group. The PC was negatively associated with the erythrocyte membrane microviscosity and erythrocyte filtration index. The PE was negatively related to the erythrocyte membrane microviscosity, while the sphingomyelin(SM) exhibited a positive correlation with the erythrocyte membrane microviscosity.It was also found that the erythrocyte membrane cholesterol and CHO/TPL ratios were markedly higher, while the erythrocyte deformability was lower in the patients with brain arteriosclerosis when compared with the controls, but no significant differences was present in the membrane total and individual phospholipids. Conclusion These results indicated that the erythrocyte membrane phospholipids, especially PE and PC, produced serious metabolic disorders and had an effect on the rheological properties of the erythrocytes in ischemic stroke.

关 键 词：脑缺血 红细胞膜 磷脂类 血液流变学 中风 

分 类 号：R743.3[医药卫生—神经病学与精神病学]