中风急性期血清血脂脂蛋白亚组分与辨证关系

The relationship between the subconstituent of lipoprotein of blood lipid of serum in the acute period of apoplexy and ite differentiation

观察５５例急性期中风患者血清血脂及其亚组分胆固醇的变化，结果缺血性甘油三脂（ＴＧ）、胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－ｃ）、极密度脂蛋白胆固醇（ＶＬＤＬ－ｃ）明显高于出血性中风（Ｐ＜０．０５～０．００１）；高密度脂蛋白胆固醇（ＨＤＬ－ｃ）则出血性高于缺血性中风；但ＨＤＬ２－ｃ降低则是两者的共同特点。ＨＤＬ－ｃ、ＨＤＬ２－ｃ、ＨＤＬ２－ｃ／ＨＤＬ３－ｃ呈风火上扰＞痰瘀痹阻＞气虚血瘀；ＬＤＬ－ｃ、ＴＣ／ＨＤＬ－ｃ、ＴＣ－ＨＤＬ．ｃ／ＨＤＬ．ｃ、ＬＤＬ－ｃ／ＨＤＬ－ｃ则呈气虚血瘀＞痰瘀痹阻＞风火上扰。提示中风患者的防治，在调升ＨＤＬ－ｃ过程中，提高ＨＤＬ２－ｃ的临床意义更大；中风虚证患者动脉粥样硬化程度较实证者重，补虚化瘀是防治中风的重要法则，调治血脂代谢异常是化瘀通络的重要途径。

The serum lipid lipoprotein subfractions of 56 patients was observed.The results showed that the TG,TC,LDL-c,VLDL-c in ischemic stroke was significantly higher than those in hemorrhagic stroke( P <0.05￣0.01);While HDL-c in the latter was higher than that in the former.Both ischemic and hemorrhagic stroke had the lower HDL 2-c,The increase of HDL-c,HDL 2-c,HDL 2-c/HDL 3-c was in the folowing order:the type of wind-fire rise>of phlem-blood stasis stagnation>of qi deficiency and blood stasis.The lift of LDL-c,TC/HDL-c,TC-HDL-c/HDL-c,LDL-c/HDL-c was in the folowing order of the type of qi deficiency and blood stasis>of phlem-blood stasis stagnation>of wind-fire rise.The above results indicated that increasing HDL 2-c is more important during the prevention and treatment of stroke.The patients of stroke with deficiency syndrome had more severe atherosclerosis than those with excess syndrome.The regulation of blood lipid disorders is a main way of removing the blood stasis and smoothing the channels and collaterals.