摘要
目的 探讨急性脑梗死并高血压患者血清脂蛋白（a）（Lp（a））、纤溶酶原激活物抑制物-1（PAI-1）水平的变化及临床意义.方法 选择急性脑梗死并高血压患者54例,单纯急性脑梗死患者42例.均行经颅彩色多普勒（TCD） 、头颅MRI及MRA检查.选择30例健康体检者为对照组.检测所有患者血清Lp（a）、PAI-1水平,比较不同脑动脉供应系统和不同血管狭窄程度、不同梗死面积患者血清Lp（a）、PAI-1水平变化.结果 ①单纯急性脑梗死组Lp（a）,PAI-1水平显著高于对照组,合并高血压组高于单纯急性脑梗死组,差异均有统计学意义（P〈0.01）;Lp（a）与PAI-1活性显著正相关（r=0.75,P〈0.01）.②不同梗死面积脑梗死患者组间Lp（a）水平呈现大梗塞灶〉小梗塞灶〉腔隙性梗塞的特点,差异具有统计学意义（P〈0.05）.③动脉狭窄以颈内动脉系统发生率最高（70.6%）,颈内动脉系统Lp（a）水平与椎基底动脉系统相比,差异无统计学意义（P〉0.05）.④多发脑动脉狭窄患者Lp（a）水平高于单支动脉狭窄患者（P〈0.05）.结论 Lp（a）,PAI-1与高血压对急性脑梗死的发生具有协同作用.Lp（a）,PAI-1作为急性脑梗死的危险因素,可预测患者的梗塞面积和颅内血管梗阻的严重程度.
Objective To study the change of lipoprotein（a） （Lp（a） ） and PAI-1 in patients with acute cerebral infarction accompanied with hypertension. Methods The subjects were divided into three groups： cerebral infarction and hypertension group（44 cases） , cerebral infarction group（42 cases） and the control group（30 healthy people）. The patients in the first two groups underwent TCD, MRI and MRA examination. For all patients,the concentration of plasma Lp（a） and PAl-1 were measured. Results （1）The plasma Lp（a） and PAI-I level in acute cerebral infarction group were higher than that of the control group （ P 〈 0.01） , and the level in acute cerebral infarction with hypertension group was higher than without hypertension group. The expression of PL（ a） has positive correlation with that of PAI-1. （2）With the ischemic area increasing, PL（a） concentration increased significantly （P 〈 0.05）. （3）There was no conspicuous change（ P 〉 0.05） in PL （a） concentration between internal carotid artery system and basilar ＇artery system. （4）The plasma Lp（a） level was higher in multiple stenosis than that in single stenosis （ P 〈 0.05 ）. Conclusions Lp （ a ） , PAI-1 and hypertension have joint action on cerebral infarction. The level of Lp （a） and PAI-1 could be used as the risk factors for acute cerebral infarction.
出处
《潍坊医学院学报》
2010年第1期29-31,共3页
Acta Academiae Medicinae Weifang
关键词
脑梗死
脂蛋白(a)
高血压
危险因素
Acute cerebral infarction
Lipoprotein（ a ）
Hypertension
Risk factor
