老年糖尿病性脑梗死患者血清脂蛋白(а)水平的变化

Change of serum lipoprotein(а) levels in elderly patients with diabetic cerebral infarction

目的探讨老年糖尿病性脑梗死（CI）患者血清脂蛋白（а）[Lp（а）]的水平变化。方法根据病史及空腹血糖水平,将272例老年CI患者分为糖尿病CI组（DCI组,128例）和非糖尿病CI组（NDCI组,144例）,另设正常对照组160人,分别检测其血清Lp（а）、血脂、血糖、体质量指数（BMI）;对CI两组行影像学检查,并进行比较。结果与正常对照组血清Lp（а）水平[（148.4±145.5）mg/L]比较,DCI组[（398.0±132.9）mg/L]与NDCI组[（253.2±119.3）mg/L]明显增高（均P〈0.01）;DCI组明显高于NDCI组（P〈0.01）。DCI组三酰甘油（TG）[（3.62±1.76）mmol/L]、低密度脂蛋白（LDL）[（4.63±0.79）mmol/L]水平较NDCI组[（1.50±0.37）mmol/L、（3.20±0.80）mmol/L]明显增高,而高密度脂蛋白（HDL）水平[（0.85±0.33）mmol/L]较NDCI组[（1.77±0.81）mmol/L]明显降低（P〈0.05~0.01）,总胆固醇（TC）水平差异无统计学意义。DCI组BMI[（26.72±2.67）kg/m2]明显高于NDCI组[（23.12±2.11）kg/m2]（P〈0.01）。影像学结果显示,DCI组以腔隙性脑梗死多见（46.9%）,而NDCI组以单发性脑梗死多见（52.8%）。结论 Lp（а）水平升高与老年DCI发病密切相关。

Objective To investigate the change of serum lipoprotein（а） level in elderly patients with diabetic cerebral infarction（CI）.Methods 272 elderly patients with CI were devided into two groups,diabetic cerebral infarction（DCI） group（n=128） and non-diabetic cerebral infarction（NDCI） group（n=144） according to their history and fasting blood glucose（BG） level.160 healthy elderly persons as control were enrolled in this study.The levels of serum Lp（а）,the blood lipids,BG and body mass index（BMI） were measured respectively,and took the image examination.The results were compared among the 3 groups.Results Compare with the level of the Lp（а） in normal control group[（148.4±145.5）mg/L],DCI group[（398.0±132.9）mg/L] and NDCI group[（253.2±119.3）mg/L] were obviously increased,there were significant differences（all P0.01）,and DCI group was apparently higher than NDCI group（P0.01）.The levels of triglyceride（TG）[（3.62±1.76）mmol/L] and low-density lipoprotein cholesterol（LDL-C）[（4.63±0.79）mmol/L]in the elderly DCI group were obviously increased than NDCI group[（1.50±0.37）mmol/L,（3.20±0.80）mmol/L],but high-density lipoprotein（HDL）[（0.85±0.33）mmol/L] was obviously decreased than NDCI group[（1.77±0.81）mmol/L],there were significant differences（P0.05-0.01）.There was no significant difference in the level of total cholesterol（TC） between the two group.Compared with NDCI group[（23.12±2.11）kg/m2],BMI in the DCI group[（26.72±2.67）kg/m2] was obviously increased,there was significant difference（P0.01）.Lacunar infarction is most common in the image results of DCI group（46.9%）,but the single infarction is most common in NDCI group（52.8%）.Conclusion The level of serum Lp（а） is closely connected with elderly DCI.