不同年龄段及不同性别椎基底动脉供血不足患者血脂与血管波动指数的特点

Characteristics of blood fat and blood vessel fluctuation exponent in patients with vertebrobasilar arterial insufficiency at different age period and different sex

目的:探讨不同年龄段和不同性别的椎基底动脉供血不足患者的经颅多普勒血管波动指数值差异与血脂间的关系。方法:收集2002-01/2004-03中南大学湘雅医院收治的椎基底动脉供血不足住院患者110例(33～50岁26例,男15例,女11例;51～87岁84例,男45例,女39例),同期健康体检者60人(33～50岁20人,男10人,女10人;51～87岁40人,男20人,女20人)。所有被试者抽血测血脂,并做经颅多普勒检查得出血管波动指数,两组均按年龄段比较不同性别患者的血脂和血管波动指数。结果:按意向处理分析,170例被试者均进入结果分析。①30～50岁年龄组血脂结果:两组女性间比较无差异(P>0.05),男性椎基底动脉供血不足患者三酰甘油和低密度脂蛋白胆固醇高于健康对照组犤(1.78±1.44),(1.03±0.38)mmol/L;(2.53±0.96),(2.20±0.70)mmol/L,P<0.05犦,高密度脂蛋白胆固醇低于健康对照组犤(1.20±0.33),(1.40±0.31)mmol/L,P<0.05犦。②30～50岁年龄组血管波动指数:男性椎基底动脉供血不足患者显著高于健康对照组(0.89±0.23,0.65±0.15,P<0.01),女性间比较无差异。③51～87岁年龄组血脂结果:男性和女性椎基底动脉供血不足患者三酰甘油均高于健康对照组犤(1.61±0.90),(1.26±0.84)mmol/L;(1.57±0.72),(1.25±0.72)mmol/L,P<0.05犦,其他各项两组间均无差异。④51～87岁年龄组血管波动指数无论男、女均无差异。结论:年轻椎基底动脉供血不足患者,其血管波动指数值、血脂在男女间有明显差别;而50岁以上,男女有无椎基底动脉供血不足症状其血管波动指数值在统计学上无显著差异,但血中三酰甘油明显升高。这提示不同年龄段、不同性别间椎基底动脉供血不足的发病机制可能不同。

AIM： To explore the relationship between the difference of transcranial Doppler （TCD） blood vessel fluctuation exponent and blood fat in patients with vertebrobasilar arterial insufficiency at different age period and different sex. METHODS： 110 inpatients with vertebrobasilar arterial insufficiency from Xiangya Hospital of Center South University from January 2002 to. March 2004 （33-50 years old 26 cases with 15 male patients and 11 female patients; 51-87 years old 84 cases with 45 male patients and 39 female patients） and 60 cases （33-50 years old 20 people with 10 males and 10 females; 51-87 years old 40 people with 20 males and 20 females） were selected. The blood fat of quizzes was detected with exsanguinating, and blood fluctuation exponent was detected with TCD. The blood fan and blood fluctuation exponent of patients of different sex was compared at the different ages in the two groups. RESULTS： According to intention-to-treat analysis, 170 cases were all inv olved in the result analysis. ① The blood result of 30-50 years old group： There was no difference among the females in the two groups （P 〉 0.05）. The tfiacylglycerol and low density lipoprotein （LDL） cholesterol of male patients with vertebrobasilar arterial insufficiency were higher than those in healthy control group [（1.78±1.44）, （1.03±0.38）mmol/L; （2.53±0.96）,（2.20±0.70）mmol/L, （P 〈 0.05）]. The high density lipoprotein （HDL） was lower than that in healthy control group [（1.20±0.33）, （1.40±0.31）mmol/L,（P 〈 0.05）]. ② The blood fluctuation exponent in 30-50 years old group： It was significantly higher in male patients with vertebrobasilar arterial insufficiency than that in healthy control group （0.89±0.23, 0.65±0.15, P〈0.01 ）. There were no differences in the females. ③ The blood fat result in 51-87 years old group： The tfiacylglycerol in male and female patients with vertebrobasilar arterial insufficiency was significantly higher than that in healthy control group [（1.61±0.90）, （1.26±0.84）mmol/L; （1.57±0.72）, （1.25±0.72）mmol/L, P〈0.05]. There were no differences of other items between the two groups. ④ The blood fluctuation exponent in 51-87 years old group： There were no differences between the males and females. CONCLUSION： The blood fluctuation exponent and blood fat in young patients with vertebrobasilar arterial insufficiency has significantly difference between males and females; While over 50 years old, there are no significant differences in blood fluctuation exponent on statistics between males and females in patients with or without vertebrobasilar arterial insufficiency symptom, but tfiacylglycerol in blood increases significantly. It is indicated that the pathogenesis of vertebrobasilar arterial insufficiency in different age period and different sex may be different.