Research Of The Relationship Between The Concentration About ADMA,eNOS,NO With Acute Cerebral Infarction

Purpose:Ischemic cerebrovascular disease has high morbidity and mortality both at home and abroad,damage in endothelial function of cardiovascular and cerebrovascul -ar diseases(CCD) be considered as a widespread phenomenon,with the developing of its research,the treatments are divided into improving the lack of regional blood supply gradually and protect the ischemic nerve cells,with in these the nitric oxide (NO) which be produced by vascular endothelial cells is an inportant intrinsic agent in regulate cerebral blood flow and protect nerve cells.Under physiological condition ,NO is released sustainly,L-arginine as its substrate and mainly by endothelial nitric oxide synthase(eNOS) catalytic generated.ADMA is the analogues of L-arginine, and it can compete with eNOS active site to inhibit the activity of NOS,thus will to reduce the generation of NO,resulting in endothelial dysfunction.This study through exam the levels of ADMA in plasma and NO,eNOS levels in serum about patients of who suffered with cerebral infarction combined with or not hypertension.In order to explore the pathogenesis of CCD that through ADMA induced,on the other hand,to explore the neuroprotective effect of eNOS.All of these will be benefit to cerebral infarction in clinical intervent early and drug treatment.Moreover,it will providing theoretical guidance and objective basis to cerebral infarction.Methods:Select fifty cases who suffered with acute cerebral infarction but normote -nsive,sixty cases of acute cerebral infarction with hypertension,and fifty cases of healthy controls,three groups of age,sex matched.Patients who presented with in one-week after the onset,and collected venous blood after fasting at least twelve hours,then examed the levels of ADMA,NO and eNOS each group.ADMA was examed by HPLC,NO was examed by nitrate reductase method,eNOS was examed by enzyme-linked ELISA method.Value to mean±standard deviation of that result, all statistical analyses were performed with the statistical software SPSS11.5.Results:1.Acute cerebral infarction with normal blood pressure group plasma ADMA level was(0.73±0.16μmol/L),cerebral infarction with hypertension plasma ADMA level was(1.03±0.22umol/L),the healthy control group,plasma ADMA level was 0.47±0.16umol/L,there have statistically significant difference among there groups(p＜0.05).Moreover,ADMA and the level of hypertension were positive -ly correlated(p＜0.01),there were non-related to age,TC,TG,smoking,drinking and other factors.2.Cases of infarction patients with hypertension whose eNOS level was(47.61±20.2 1U/ml),significantly lower than the normal blood pressure group which eNOS level was(55.70±18.96U/ml)(p＜0.05),and both lower than the normal control group,its eNOS levels in serum(66.54±24.13U/ml)(P＜0.05).3.NO level in Infarction combined with hypertension group was(55.28±10.78umol /L),the group cerebral infartion but normal blood pressure whose serum NO level was(60.20±14.03umol/L),there were not significant difference between the two groups(p＞0.05),but were lower than NO level of the control group(70.27±6.78 umol/L),the difference has statistical significance(p＜0.05).4.Determination of high blood pressure(HBP) classification at all levels with hypert -ension in patients with cerebral infarction inspection indicators:patients of HBP classl whose plasma ADMA level of 0.74±0.23umol/L,were significantly lower than class 2 and 3 patients(whose ADMA levels to(0.96±0.17 umol/L) and(1.05±0.11 umol/L),and between the later two groups was not significant different (p＞0.05);eNOS levels among three HBP groups show:classⅠwas of(51.27±16.76 umol/L),class 2 group was 49.43±19.22umol/L,both they were higher than class 3 group(45.45±14.10 umol/L),and have significant differences(p＜0.05);three groups of patients with serum NO concentrations were(53.16±11.48 umol/L), (50.87±16.03 umol/L) and(46.02±16.82 umol/L),but there were no significant differences(p＞0.05).5.After the OCSP classification founded that level of ADMA in both TACI and PACI were higher than LACI;eNOS level in TACI and POCI were lower than LACI group; and the NO level in TACI was lower than LACI.The differences were significant.6.Pearson-correlation analysis showed:normal blood pressure group cerebral ADMA levels with eNOS were negative correlation(r=-0.501,p＜0.05);cerebral infarction combined with hypertension group ADMA levels with eNOS were also negatively correlated(r=-0.717,p＜0.05).ADMA and NO levels were negatively correlated between two groups,correlation coefficients were -0.484 and -0.312. 7.Respectively,the traditional risk factors for cerebral infarction such as gender,age, hypertension,diabetes,smoking,drinking,etc.and ADMA to do one-factor analysis, statistic standard is p＜0.05,it will be removed if p＞0.05,and factors of p＜0.05 were performed the multiple stepwise Logistic regression analysis found that in the control of other traditional risk factors of ischemic cerebrovascular disease,elevated plasma ADMA levels was still a independent risk factor.Conclusion:The levels of ADMA in plasma were higher significantly in acute cerebral infarction,but levels of eNOS in serum were lower obviously,indicated that vascular endothelial dysfunction was prevalence in cerebral infarction.There have significant difference in the levels of ADMA and eNOS which in the two groups—CI combined with hypertension and CI but normotension group,the finding suggesting that there have correlation between the hypertension with levels of ADMA and eNOS, and there were correlation with the degree of hypertension.On the other hand,based on OCSP classification,ADMA may be close correlated with cerebral infarction area. ADMA was negatively correlated with eNOS,eNOS as a key enzyme in produce NO, so the quantity and biological effects of NO will be regulated directly by eNOS,thus, we think that the influence of ADMA to vascular endothelial function through the eNOS/NO pathway.Controlling for other factors,the multi-factor analysis showed that ADMA may serve as an independent risk factor for cerebral infarction,it can be used as predict factor for stroke.As a result,ADMA will be as a treatment target of CI and may expe -cted to reduce its morbidity and mortality.