心脑血管疾病患者的血液流变学指标与血脂水平分析(英文)

Analysis of hemodynamics and serum lipids concentration in patients with cardiac and cerebrovascular diseases

背景:关于动脉粥样硬化的发病机制研究者多关注脂质代谢紊乱的变化和情况。但以血液流变学指标与血脂指标水平的关联分析研究报道较少。目的:探讨血液流变学指标,血清脂蛋白a等血脂其他指标水平及其相关性与血栓性疾病的关系。设计:以诊断为依据的病例对照研究。地点和对象:选择2001-08/2002-10在武汉大学中南医院神经内科确诊的脑梗死患者(脑梗死组)68例(年龄49～81岁,男42例,女26例)。在武汉大学中南医院心血管内科确诊的心肌梗死患者(心肌梗死组)49例(年龄50～87岁,男29例,女20例)。对照组为无心、脑血管疾病的健康志愿者及献血员98例(年龄43～76岁,男56例,女42例)。方法:对68例脑梗死患者、49例心肌梗死患者、98例健康对照组进行血液流变学指标和脂蛋白a等其他各血脂指标的检测,并进行统计学分析。主要观察指标:血液流变学指标和脂蛋白a等其他血脂指标。结果:脑梗死组和心肌梗死组总胆固醇、三酰甘油,高密度脂蛋白胆固醇、脂蛋白a水平均明显高于对照组(t=2.48～2.70,P<0.01);低密度脂蛋白胆固醇明显低于对照组(t=2.63～2.66,P<0.01);载脂蛋白A1、载脂蛋白B与对照组比较,差异无显著性意义(t=0.89～1.39,P>0.05);脑梗死组和心肌梗死组血液流变学指标显著高于对照组(t=2.43～2.65,P<0.01);

BACKGROUND:Studies on the mechanisms of atherosclorosis(AS) preferably focus on the disturbed lipoprotein metabolism.There are lack of studies on the relationship between hemodynamics and the serum lipids concentration.OBJECTIVE:To investigate the relationship between hemodynamics and the level of serum lipids concentration and their association and formation of thrombosis.DESIGN:A case-control study based on diagnosis.SETTING and PARTICIPANTS:Cerebral infarction group included 68 patients(aged 49-81 years old,42 males and 26 females)who were diagnosed to have cerebral infarction in the Department of Neurology,Zhongnan Hospital of Wuhan University.The cardiac infarction group consisted 49 patients(aged 50-87 years old,29 males and 20 females).Ninety-eight healthy candidates aged 43-76 years old(56 males and 42 females) without cardiac cerebrovascular diseases were involved in the control group. INTERVENTIONS:Data of hemodynamics and serum concentration of moncysteine a and other lipidoproteins were collected from all subjects.Statistical analysis was performed.MAIN OUTCOME MEASURES:Indexes of hemodynamics,moncysteine a, and lipids. RESULTS:It was shown significant higher levels of serum cholesterol,triglycerides,high density lipoprolein cholesterol(HDL-C) and moncysteine a in cerebral and cardiac infarction groups than those in the control group.There was significant lower levels of serum low density lipoprolein cholesterol(LDL-C) in infarction groups than those in the control group.Hemodynamic indexes were significantly higher in the infarction groups.There was no significant difference in the levels of serum apolipoprotein A and B between infarction groups and control group.The association between hemodynamic indexes and serum lipid concentration was F=14.3428,R2=0.4194 in cardiac infarction group and F=13.2756,R2=0.3515 in cerebral infarction group.The association was not of statistic significance.CONCLUSION:Monitoring hemodynamics and serum lipid level is of clinical importance for controlling cardiac and cerebral sclerotic diseases and prevention of recurrence of cerebral cardiac accidents.