脑血管病与血脂蛋白谱关系的研究

Analysis of serum lipoprotein pattern with cerebrovascular diseases patients

目的：探讨血脂、脂蛋白、载脂蛋白（ａｐｏ）ＡⅠ、ＡⅡ、Ｂ、ＣⅡ、ＣⅢ、Ｅ在脑血管病发病中的意义及其作用。方法：选择脑梗塞病人１６５例，脑出血病人１３５例，健康对照组３０例，空腹采静脉血，测定血脂蛋白谱。结果：脑梗塞病人Ｌｐ（ａ）显著增高，高密度脂蛋白－Ｃ（ＨＤＬ－Ｃ）、ａｐｏＡⅠ显著降低，脑出血病人ａｐｏＥ显著增高。脑梗塞与脑出血共同存在着ａｐｏＡⅠ／ａｐｏＢ比值降低，ａｐｏＡⅠ、ＨＤＬ－Ｃ、ａｐｏＣⅡ的降低及甘油三酯（ＴＧ）、ａｐｏＣⅢ、低密度脂蛋白－Ｃ（ＬＤＬ－Ｃ）的升高。逐步回归分析优选风险度指标：脑梗塞首选Ｌｐ（ａ），脑出血首选ａｐｏＥ，脑血管病首选ａｐｏＡⅠ／ａｐｏＢ。结论：脑血管病病人存在着血脂代谢的异常，脑梗塞与脑出血的血脂代谢存在差异。应对脑血管病病人进行血脂干预性治疗。

A study was performed to determine whether differences existed in regard to serum lipid lipoprotein and apolipoprotein AⅠ, AⅡ,B,CⅡ,CⅢ,E in cerebrovascular diseases. Method:165 patients with cerebral infarction 135 patients with cerebral hemorrhage and 30 normal controls were selected to have their serum lipoprotein examined. Lp(a) were analyzed with well stardardized ELISA methods. All the Apo were determined by immunoturbidimetric methods. Results:[HTSS]patients with cerebral infarction and cerebral hemorrhage had either high levels of TG, apoCⅢ & LDLC or low levels of apoAⅠ/apoB,HDLC, apoCⅡ. Increased level of Lp(a), decreased level of HDLC and decreased level of apoAⅠ are the risk factors of cerebral infarction, increased level of apoE is the risk factor of cerebral hemorrhage. Progressive regression analysis selected Lp(a)is the first choice of discriminator for cerebral infarction, apoE for cerebral hemorrhage, apoⅠ/apoB for cerebrovascular diseases.