急性脑卒中与血清胆红素相关关系及血脂水平的临床观察

Study on the relationship of acute cerebral stroke with serum bilirubin and plasma lipid

目的:研究脑梗死和脑出血急性期血清胆红素及血脂的变化及临床意义。方法:对42例脑梗死和23例脑出血患者的血清总胆红素(TB)、直接胆红素(DB)、载脂蛋白A1(APOA1)、载脂蛋白B(APOB)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)进行检测,并与30例对照组进行对比分析。结果:脑卒中的TB、DB均明显高于对照组,差异具有显著意义(P<0.01),脑梗死组的APOB、TG、TC均较对照组明显升高(P<0.01),而LDL-C升高也较为明显(P<0.05),HDL-C降低(P<0.05)。脑出血患者血脂APOA1、TC升高(P<0.01/0.05)。结论:脑出血和脑梗死患者在急性期的TB、DB均显著升高,并认为可能是卒中后并发症及应激状态所致。卒中急性期的胆红素升高可以通过其抗氧化保护组织细胞作用而对抗卒中后的高脂血症,有利于降低血黏度和保护脑细胞,所以,卒中后高胆红素血症可能是一种自我保护的应激反应。

Objective:To observe the relationship of acute cerebral stroke with serum bilirubin,plasma and lipid.Methods:The serum total bilirubin(TB),direct bilirubin(DB)and plasma lipid(apoA1,apoB,TG,TC,HDL-c and LDL-c)were measured in 42 cases with acute cerebral infarction and 23 cases with acute cerebral hemorrhage and was in contrast with 30 healthy people.Results:The serum level of TB,DB of acute cerebral stroke groups was significantly higher than control group(P<0.01).The plasma lipid(APOB,TG and TC)of acute cerebral infarction group were higher than control group(P<0.01),and its LDL-C is obviously higher than control group(P<0.05).Its HDL-C is significantly lower than control group(P<0.05).The serum level of apoA1 and TC of cerebral hemorrhage group were significantly higher than control group(P<0.01/(0.05).)Conclusions:The serum TB、DB of acute cerebral stroke are raise.Rising LDL-C,APOB and lowing HDL-C are related to the occurrence of cerebral infarction.