城市居民血清甘油三酯、总胆固醇和高密度脂蛋白胆固醇水平对预防脑卒中的意义

THE LEVELS OF TG TC AND HDLIN PATIENTS WITH HYPERTENSION CORONARY HEART DISEASE AND DIEBETES AND THEIR PREDICTIVE VALUE FOR STROKE

1987年,我们在北京市崇文和西城两区进行了脑血管病的干预试验研究,在两区各选一含10,000人口的社区分别作为干预组和对照组,对35岁以上的人群进行了基线调查,随机抽取其中的40%进行血清TG、TC、HDL—C检查,之后开始实施干预.至1990年12月31日止,干预组和对照组分别有新发脑卒中病例24例(CI 17例,CH 7例)和34例(CI 26例,CH 8例).回顾病人基线血脂发现,其血清TC均明显高于正常人,而HDL-C/TC低于正常人.回顾其病史发现,干预组和对照组分别有23.54%和38.46%的CI病人在病前未患高血压、冠心病或糖尿病,但其平均TC高于正常人,HDL-C/TC低于正常人.这一结果提示在人群脑血管病防治中,若能加强对高TC或低HDL-C/TC者的管理,其效果将更为明显.

An intervention study was conducted to study the relation between blood lipids and incidence of stroke in 1987. Two communities each containing 10000 population were selected from two districts in urban areas in Beijing, and one was assigned to the intervention site and the other control. A sample was drawn randomly from the population aged 35 years and over at eaoh site for baseline survey. After the survey, a register system for stroke was established and intervention began (treatment of patients with hypertension or CHD or diabetes). The sera were drawn and examined for TC, TO and HDL in 40% of the subjects who were examined in the baseline survey (1515 men, 2050 women). From 1987 to Dec. 31 1990, 24 individuals in intervention population [17 cases were cerebral infarction (CI) , 7 cerebral hemorrhage (CH)] and 34 in control [26 CI ,8 CH]developed new events of definite stroke. The CI patients in both sites had a significantly higher level of TC (236. 00 + /4. 48mg/dl in intevention group, 211. 62 + /1. 07mg/dl in control) and lower HDL/TC(0. 25 + /. 13 in intervention, 0. 29 + /. 06 in control) than these in normal population (TC 206. 08+/1. 07, HDL/TC 0. 31+. 15). Looking into the medical history of these CI patients, 23. 54 % (intervention group) and 38. 46% (control group) of them did not have hypertension or CHD or diabetes, however their average TC (216mg/dl) was higher and HDL/TC was lower than that in normal population. These results suggest that if we strengthen our work on the people in whose sera TC was high or HDL/TC was low, the incidence of CI would decrease more greatly.