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BACKGROUND: Studies have shown that malondialdehyde is the metabolic product of lipid peroxidation. However, detection of the intermediate metabolic product of lipid peroxidation, acylhydroperoxide (AHP), has rarely been reported. OBJECTIVE: To document concentrations of the intermediate metabolic product of lipid peroxidation, AHP, during different stages of ischemic cerebral infarction. DESIGN, TIME AND SETTING: Forty-eight patients with cerebral infarction from the East Hospital of Tongji University, and thirty-three students of Shanghai Geriatric University (healthy controls), in a case match-control study from April 2000 to January 2001. PARTICIPANTS: Based on different disease states, patients were separated into three groups: acute (n = 19), convalescent (n = 17), and chronic(n = 12). The healthy, control group consisted of 33 students, who were not treated with Vitamin E during the two weeks. METHODS: AHP concentration was detected by an ultraviolet spectrophotometric method, and plasma Vitamin E levels were detected by a visual spectrophotometric method. MAIN OUTCOME MEASURES: Plasma lipid AHP and Vitamin E levels of patients and healthy control groups. RESULTS: Plasma lipid AHP levels of patients in the acute group significantly increased compared with healthy control and convalescent groups (F = 4.40, P 0.05). CONCLUSIONS: Lipid pcroxidation, as evidenced by high plasma lipid AHP and low Vitamin E levels, occurs primarily during the acute stage of patients with cerebral infarction.