脑梗塞患者血清脂蛋白（a）含量的研究

Astudyofserumlipoprotein(a)inthepatientswithcerebralinfarction

为了阐明脂蛋白（ａ）水平增高是否为脑梗塞的重要危险因素及其与不同部位梗塞的关系，采用酶联免疫吸附试验检测了８７例脑梗塞患者血清脂蛋白（ａ）［Ｌｐ（ａ）］的含量，与对照组１１２例结果进行比较。结果显示，脑梗塞患者血清中Ｌｐ（ａ）含量明显高于对照组，Ｌｐ（ａ）增高的发生率在脑梗塞组（３３．３％）、深穿支动脉闭塞（ＰＡＯ）亚组（３２．３％）及皮层支动脉闭塞（ＣＡＯ）亚组（３６．４％）均明显高于对照组（５．４％）。血清Ｌｐ（ａ）水平增高的相对危险度比数比（ＯＲ）为８．８３。此外，９例有糖尿病病史患者的血清Ｌｐ（ａ）水平较７８例无糖尿病患者明显增高，血清Ｌｐ（ａ）水平与血糖呈正相关。结果表明，血清Ｌｐ（ａ）水平增高是脑梗塞及ＰＡＯ和ＣＡＯ亚组脑梗塞的重要危险因素。血糖或糖尿病史可能是影响血清Ｌｐ（ａ）水平的因素。

Theauthorsmeasuredtheserumlipoprotein(a)[Lp(a)]levelswithanenzyme-linkedimmunosorbentassay(ELISA)in87patientswithacutecerebralinfarctionand112controlsubjects,toelucidatewhetherincreasedserumLp(a)levelswouldbeanimportantriskfactorforcerebralinfarctionandwhetherthereweretheirasociationswiththesubtypesofcerebralinfarction.TheresultsrevealedthattheserumLp(a)inpatientswithcerebralinfarctionwashigherthanthoseinthecontrols.TheincidenceofsubjectswithserumLp(a)levels≥0.52g/L,whichwasthe95thpercentilelevelofthecontrolsubjects,wassignificantlyincreasedinthetotalcerebralinfarctiongroup(33.3%)andintheperforatingarteryocclusion(PAO)group(32.3%)andthecorticalarteryocclusion(CAO)group(36.4%),ascomparedwiththecontrolgroup(5.4%).ThecrudeoddsratioofincreasedLp(a)levelsforcerebralinfarctionwas8.83.ThesefindingsindicatedthatthehighserumLp(a)levelscouldbeanimportantriskfactorforcerebralinfarctionasawholeaswelasforthePAOandCAOsubtypes.OurstudyalsosuggestedthatahistoryofdiabetesmelitusorafastinghighbloodsugarlevelmightafecttheserumLp(a)levelsinthepatientswithcerebralinfarction.