军队体检中、老年人的脂蛋白(a)与缺血性脑卒中相关性的研究

The study on the relationship between Lp(a) and ischemic stroke in the elderly in the military physical examination

目的探讨脂蛋白(a)是否为中老年人缺血性卒中的危险因素。方法对成都军区体检的6211例中老年人按照脑血管病诊断要点,并经头部CT或MRI证实,共诊断缺血性脑卒中患者501例,按CT分型标准将501例患者分为大梗死、中梗死、小梗死及腔隙性脑梗死组。对照组为同期体检的非脑血管病患者。梗死组和对照组均于体检当日清晨空腹抽取静脉血,测定Lp(a)及其他各项血脂指标,分析Lp(a)与卒中类型之间的关系。结果缺血性脑卒中组≥80岁亚组TC、TG比其它组明显减低(P<0.05);缺血性脑卒中组中、老年女性TC、TG异常总检出率高于男性;缺血性脑卒中组Lp(a)浓度及异常率均高于对照组,差异有统计学意义(P<0.05),其中中梗死组Lp(a)水平最高。结论高浓度Lp(a)可能参与了缺血性脑卒中的发生。

Objective Investigate whether Lp（a） is a risk factor of ischemic stroke in the elderly.Methods The 501 cases of ischemic stroke patients were diagnosis in accordance with cerebrovascular disease diagnosis points and approved by the head CT or MRI in the 6211 cases of the elderly participating the chengdu military physical examination.The 501 patients were divided into larger area infarction,medium area infarction,small area infarction and lacunar infarction group by CT classification standards.The elderly without infarction participating the same period check-up were used as control group.Fasting blood samples were collected on the morning when admission.Lp（a） and other serum lipid were determined by complete automatic plasma biochemistry.The relationship was analysis between Lp（a） and the kinds of stroke.Results In the ischemic stroke group,the total abnormal detection rate of TC and TG of older female was higher than those of male.The levels of TC and TG in 80 and greater than 80 years old group are lower than those of other groups（P 0.05）.The levels and abnormal rate of Lp（a） in stroke group were significantly higher than those in the controls（P0.05）,there was a significant difference in Lp（a） levels between medium area infarction group and control group.Conclusion High serum Lp（a） level may be a risk factor in ischemic stroke.