不同亚型脑卒中患者血浆Lp(a)浓度的分布比较

Comparative study of plasma lipoprotein(a) concentration in different subtype of stroke

目的研究血浆Lp(a)浓度与脑卒中发生及其亚型的关系。方法采用病例对照的研究方法,以初发脑卒中患者作为研究对象,同时以健康自愿者和非脑卒中患者为对照,共收集、组成312对病例与对照研究对。结果①流行病学调查显示,脑血栓组的吸烟者显著高于对照组;3个亚型的脑卒中有高血压病史者均显著高于对照组。②脑血栓形成者的血糖、低密度脂蛋白均显著高于对照组,但是高密度脂蛋白水平却明显低于对照组。③脑卒中的各亚型分组中,脑血栓形成和腔隙性脑梗死者的血浆对数浓度显著高于对照组;而脑出血者与对照组比较差异无显著性。④血浆Lp(a)浓度与脑卒中危险的相关分析显示,高水平的血浆Lp(a)浓度可使脑卒中总体的发病风险提高0.53倍;并且使脑血栓形成的发病风险提高0.8倍;与脑出血及腔隙性脑梗死发生无明显相关。结论①吸烟对脑卒中,特别是缺血性脑卒中的发生确有影响。②高水平的血浆Lp(a)浓度可增加脑卒中的发生危险,特别是脑血栓形成。

[Objective] To investigate the correlation between plasma lipoprotein（a） levels and the occurrence of stroke, and to study the correlation between plasma hpoprotein（a） levels and the subtypes of stroke. [Methods] To use the method of case control study, to collect 312 patients who first time suffered from stroke, and 312control who were healthy volunteer, or no-stroke patients at the same time. To compose 312 study pairs. [Results] The investigation of epidemiology indicated that there were more smokers in the group of stroke than control. There were more patients with hpyertension history in three subtypes of stroke than control. The blood glucose, low density lipoprotein （LDL） concentration in patients with cerebral thrombosis was higher than control group, but the high density lipoprotein （HDL） concentration was lower than control group. The logarithm concentration of plasma lipoprotein （a） in the patients of cerebral thrombosis and lacunar infarction was higher than control significantly; but there was no significant difference between stroke and control group. The correlation between plasma lipoprotein （a） levels and the stroke risk indicated that high Lp（a） concentration could increase the incidence of stroke by 0.53 times; and the incidence of cerebral thrombosis by 0.8 times; there was no significant correlation between lipoprotein （a） levels and the incidence of the cerebral hemorrhage and lacunar infarction. [Conclusion] Smoking can definitely affect the incidence of stroke in our research. High plasma Lp （a） concentration could ineerase the incidence of stroke, especially for the cerebral thrombinosis.