Study On Relationship Between Phlegm TCM-Syndrome Of Stroke Disease And Lipids Metabolism, Free Radical Injury And Nervous Impairment

Background: There has never been an objective standard of diagnosing the phlegm TCM-syndrome (PTS) of stroke disease ( SD) .Objectives: To detect the serum level of triglyceride(TG), total cholesterol(TC), low-density-lipoprotein-cholesterol(LDL-C), content of malondialdehyde (MDA) and activity of superoxide dismutase isozymes (including T-SOD, CuZn-SOD, Mn-SOD) and calculate the score of nervous impairment (SNI) of SD patients; so as to investigate into the relationship between PTS of SD and the three aspects indexes: the scores of nervous impairment, blood lipids and free radical injury.Materials and methods: 63 patients with SD were collected and divided into two groups: PTS group and non-phlegm TCM-syndrome (NPTS) group. All were accord with the diagnosing points of acute cerebral vascular disease and must be able to be diagnosed as one of the six TCM-syndromes based on the differentiation standards of TCM, among which 41 were male and 21 were female. The average age was 63.40+11.31years(aged 43-84 years). 30 healthy people were taken as normal control group, among which 16 were male and 14 were female, the average age was 62.37 ?9.82 years (aged 49~73years).To calculate SNI of patients with SD.To detect serum level of TG (CHOD enzyme method), TC (GPO-PAP enzyme method), LDL-C (PVC precipitation method).To detect serum content of MDA (thiobarbiturtic acid method) and activity of SOD isozymes (including T-SOD, CuZn-SOD, Mn-SOD) (xanthine oxidase method).Results: 1. There was significantly different in SNI between PTS group and NPTS group (P<0.01).2.Serum level of TG, TC, LDL-C and serum content of MDA in patients with SD were obviously higher than that of normal control group(P<0.01),while activity of SOD isoenzymes descended strikingly(P<0.01).3. Correlation between SNI and serum level of TG, TC, LDL-C was not significant in patients with SD, while there was positive correlation between the scores and serum contentof MDA, and negative correlation between the scores and serum activity of SOD isoenzymes (P<0.05.P<0.01).4. Serum level of TG, TC, LDL-C in PTS group and NPTS group was significant higher than that of normal control group (P<0.05, P<0.01) . And TG, TC, LDL-C in PTS group was notably higher than that of the NPTS group ( P<0.05, P<0.01).5. Compared with normal control group and NPTS group, serum content of MDA in PTS group increased notably (P<0.01) but activity of SOD isozymes decreased markedly especially T-SOD and CuZn-SOD (P<0.01) . And there was no significant different in serum activity of Mn-SOD between PTS group and NPTS group (P>0.05).Serum content of MDA in NPTS group increased strikingly (P<0.01) but activity of SOD isoenzymes decreased markedly (P<0.01) when compared with normal control group.6. We choose PTS, NPTS as dependent variables,and SNI, level of TG, TC, LDL-C,content of MDA, activity of T-SOD, CuZn-SOD as independent variables to take discriminant analysis. Correct rate of equations we got was 81.0%, which accorded with clinical situation.Conclusion: 1. There was serious lipids disturbance and free-radical injury in PTS patients with SD.2. Content of MDA, activity of SOD isozymes in serum can reflect the severity of stroke disease while serum level of TG, TC, LDL-C cannot.3. The score of nervous impairment and serum level of TG, TC, LDL-C and content of MDA, activity of T-SOD, CuZn-SOD can reflect the substance of PTS of SD by different P<0ints of view.4. The PTS of SD can be diagnosed standardly based on SNI, lipids metabolism (serum level of TG, TC, LDL-C) and free radical injury (serum content of MDA and activity of T-SOD, CuZn-SOD) as well. Activity of Mn-SOD cannot be an objective index for PTS of SD.