脳卒中におけるビタミンEと過酸化脂質 第2編 脳卒中発作後の血清ビタミンE,過酸化脂質,総コレステロール,遊離脂肪酸に対するビタミンE投与の影響

各種動脈硬化疾患で血清過酸化脂質が増加することが明らかにされ,動脈硬化の成因および進展に過酸化脂質が重要な役割を果たしているのではないかと注目されている.第1編で脳卒中発作後に血清過酸化脂質が増加し血清ビタミンEが減少すること,血清ビタミンE減少の一機序として脳血管障害部位での過酸化脂質生成に対してビタミンEが抗酸化剤として動員され消費される可能性を論じたが,第2編ではこの結果にもとづき,脳卒中発症直後よりビタミンEを投与し,血清ビタミンE,過酸化脂質,総コレステロール,遊離脂肪酸に対する影響を検討した.

Serum levels of α-tocopherol (α-Toc), lipoperoxide (TBARS), total cholesterol (TC) and free fatty acid (FFA) were studied before and after the administration of vitamin E (dl-α-tocopheryl acetate) for 4 weeks (400mg/day im for the first week, thereafter 600mg/day po) in the acute stage of stroke. Serum α-Toc was significantly lowel, but TBARS was higher than that of the control in the first day of outbreak. Vitamin E administration elevated the serum α-Toc level in a few days, but did not affect the TC level. On the otherhand, the serum TBARS level remained at a plateau for 4 weeks. These results led us to conclude that vitamin E must inhibit the elevation of TBARS, which otherwise was observed in most cases of stroke in the first week. There were three stroke patients whose serum α-Toc happened to have been measured 2 or 4 months prior to attack, and two of them had low levels of α-Toc (1ess than 0.5mg/dl) at that time. Soon after stroke developed, serum α-Toc was lower in the three patients. These findings suggest that a low level of serum α-Toc could be one of the risk factors of stroke.