Dynamic Change And Clinical Significance Of Heme Oxygenase-1 And Unconjugated Bilirubin In Acute Cerebral Infarction

OBJECTIVE The aim of this study was to observe dynamic changes of serum levels of Heme oxygenase-1(HO-1)and Unconjugated bilirubin(UCB)in patients with acute cerebral infarction(ACI),find out the rule of these changes and its possible mechanism in cerebral ischemic injury.METHODS 50 patients with acute cerebral infarction were included and observed for serum levels of HO-1 and UCB on the first day,the third day and the seventh day after the onset of ACI,30 healthy subjects were selected as control group.All patients were evaluated by clinical neurological deficitscores(modified Edinburgh-Scandinavia stroke scale,SSS)on the first day and classified as severe,moderate and mild group accordingly.RESULTS1.Dynamic changes of HO-1 and UCB levels in the blood serum Serum levels of HO-1 and UCB in ACI group were detected to increase on the first day, which were significantly higher than those in the control group(p＜0.01); Both serum levels of HO-1 and UCB on the third day and the seventh day decreased significantly compared with those on the first day(p＜0.01),with UCB serum levels significantly lower than those of the control group (p＜0.01),while HO-1 serum levels of the third day and the seventh day did not reach statistically significant difference compared with the control group(p＞0.05).2.Comparisons among different groups The serum level of HO-1 of the first day increased with the severity of clinical conditions,the difference were significant by comparing among different group(p＜0.05). Serum,levels of UCB also increased with the increasing SSS score,but did not reach statistically significance among different groups(p＞0.05). Although both serum levels of HO-1 and UCB decreased on the third day and the seventh day among different groups,UCB serum levels in the mild group still maintained at a relatively high level which were significantly different from the moderate and severe groups(P＜0.01).3.On the first day after the onset,Serum levels of UCB in ACI patient were positively correlated,with that of HO-1(p＜0.01);Serum HO-1 levels on the first day were positively correlated with the SSS score(p＜0.01); while serum UCB levels on the third day and the seventh day were negatively correlated with the SSS score(p＜0.01).CONCLUSIONS1.The increased HO-1,UCB level may be some defensive reaction of the body against cerebral ischemic injury in acute stage.2.The function of the elevated HO-1 was transient,and the UCB level increased accordingly to the level of HO-1.3.The elevated levels of HO-1,UCB may have some protection role in the pathogenic process of cerebral infarction.