脑蛋白水解物对急性脑卒中患者Nrf2氧化应激信号通路的影响

doi:10.3969/j.issn.1004-583X.2021.11.007

摘要/Abstract

摘要：

目的探讨急性脑卒中患者应用脑蛋白水解物对核因子-E2相关因子2为核心的 Keap1-Nrf2/ARE(Nrf2)氧化应激信号通路的影响。方法选取我院2017年10月至2020年10月收治的急性脑卒中患者195例,按照治疗方法分为研究组(n=98)与对照组(n=97)。对照组予改善脑循环、改善脑功能、抗血小板聚集等常规药物治疗,研究组基于对照组方案,再加用脑蛋白水解物治疗,两组均治疗14 d。观察对比两组疗效。观察对比两组治疗前后国立美国卫研院卒中量表(NIHSS)评分及日常生活活动能力(Barthel)指数的改变情况。观察对比两组治疗前后血清炎性因子肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-19(IL-19)水平的改变情况。观察对比两组治疗前后氧化应激指标血清歧化酶-超氧化物(SOD)、丙二醛(MDA)水平的改变情况。观察对比两组治疗前后血管内皮功能血清脂联素(APN)、血管性因子-假血友病(vWF)的改变情况。观察对比两组治疗前后 Nrf2氧化应激信号通路 Keap1、NQO1、ARE、Nrf2蛋白表达的改变情况。结果研究组总有效率达到91.84%,对照组总有效率60.82%,差异有统计学意义(P<0.01)。研究组治疗后NIHSS评分显著低于对照组,Barthel指数显著高于对照组(P<0.01)。研究组治疗后血清炎性因子TNF-α、IL-8、IL-19、MDA、vWF及Keap1水平显著低于对照组,血清 SOD、APN、NQO1、ARE及Nrf2水平显著高于对照组,差异有统计学意义(P<0.01)。结论急性脑卒中患者应用脑蛋白水解物治疗,对Nrf2氧化应激信号通路相关蛋白能够有效调节,对血管内皮功能的改善、炎症及氧化应激的控制、神经功能及生活质量的提高,均具有显著效果。

关键词: 卒中, 脑蛋白水解物, 氧化应激, 信号通路

Abstract:

Objective To explore the effect of cerebroprotein hydrolysate on nuclear factor-E2 correlation factor 2-cored Keap1-Nrf2/ARE (Nrf2) oxidative stress signaling pathway in patients with acute stroke (AS). Methods Totally 195 AS patients treated in the hospital from October 2017 to October 2020 were divided into study group (n=98) and control group (n=97) according to therapeutic methods. The patients in control group were administered with conventional therapies involving the enhancement of cerebral circulation, improvement of brain function and antiplatelet aggregation, and patients in study group additionally with cerebroprotein hydrolysate on the basis of control group. All patients were treated for 14 days, the efficacy was observed, The key observation was National Institutes of Health Stroke Scale (NIHSS) score, Activity Ability-daily Life (Barthel) Index, inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-8(IL-8) and interleukin-19(IL-19) oxidative stress indexes including serum superoxide dismutase (SOD), malondialdehyde (MDA), vascular endothelial function such as serum adiponectin (APN), and plasma von Willebrand factor (vWF), protein expressions of Nrf2 oxidative stress signaling pathways Keap1, NQO1, ARE and Nrf2.Results Total effective rate in study group (91.84%) and control group (60.82%) was statistically significant difference (P<0.01). After treatment, NIHSS score were significantly lower in study group than in control group. Barthel index was significantly higher in study group than in control group (P<0.01). TNF-α, IL-8, IL-19, MDA, vWF and Keap1 were significantly lower in study group than in control group. Serum SOD, APN, NQO1, ARE and Nrf2 were significantly higher in study group than in control group(P<0.01). Conclusion For AS patients, cerebroprotein hydrolysate can effectively regulate Nrf2 oxidative stress signaling pathway related proteins, and deliver significant effects in improving the vascular endothelial function, controlling inflammation and oxidative stress, and enhancing the neurological function and quality of life.

Key words: stroke, brain protein hydrolysate, oxidative stress, signal pathway

中图分类号:

R743

刘亭, 姬卫东, 杨青松. 脑蛋白水解物对急性脑卒中患者Nrf2氧化应激信号通路的影响[J]. 临床荟萃, 2021, 36(11): 996-1000.

Liu Ting, Ji Weidong, Yang Qingsong. Effects of cerebroprotein hydrolysate on Nrf2 oxidative stress signaling pathway in acute stroke patients[J]. Clinical Focus, 2021, 36(11): 996-1000.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.11.007

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I11/996

图/表 6

参考文献 20

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组别	例数	基本控制	显效	有效	总有效
研究组	98	16(16.32)	51(52.04)	23(23.46)	90(91.84)
对照组	97	6(6.18)	25(92.59)	28(28.86)	59(60.82)
χ²值			7.819		26.010
P值			0.020		<0.01

组别	例数	基本控制	显效	有效	总有效
研究组	98	16(16.32)	51(52.04)	23(23.46)	90(91.84)
对照组	97	6(6.18)	25(92.59)	28(28.86)	59(60.82)
χ²值			7.819		26.010
P值			0.020		<0.01

组别	例数	NIHSS评分		Barthel指数
组别	例数	治疗前	治疗后	治疗前	治疗后
研究组	98	24.16±4.23	7.39±2.41^*	53.26±5.77	86.71±3.68^*
对照组	97	24.74±3.85	12.65±1.51^*	54.23±4.85	74.72±3.87^*
t值		1.001	18.242	1.270	22.172
P值		0.318	0.000	0.206	0.000

组别	例数	NIHSS评分		Barthel指数
组别	例数	治疗前	治疗后	治疗前	治疗后
研究组	98	24.16±4.23	7.39±2.41^*	53.26±5.77	86.71±3.68^*
对照组	97	24.74±3.85	12.65±1.51^*	54.23±4.85	74.72±3.87^*
t值		1.001	18.242	1.270	22.172
P值		0.318	0.000	0.206	0.000

组别	例数	TNF-α(μg/L)		IL-8(μmoL/L)		IL-19(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	98	16.15±5.29	7.39±2.13^*	29.87±6.27	15.88±3.71^*	81.13±28.77	22.87±4.19^*
对照组	97	16.38±4.85	12.46±3.25^*	29.55±5.39	21.77±4.28^*	80.51±28.15	37.65±8.33^*
t值		0.316	12.896	0.382	10.272	0.152	15.675
P值		0.752	0.000	0.703	0.000	0.879	0.000