血清脂蛋白a水平与脑梗死及颈动脉粥样硬化关系的临床研究

Clinical investigation on relationship among lipoprotein（a） ,cerebral infarction and carotid atherosclerosis

目的 探讨血清脂蛋白a[Lp（a）]水平与脑梗死及颈动脉粥样硬化的相关性.方法 比较脑梗死伴颈动脉粥样硬化患者60例（脑梗死组）、颈动脉粥样硬化不伴脑梗死患者60例（简称无脑梗死组）及健康体检者60例（对照组）的血清Lp（a）水平、异常值检出率,以及常见的脑梗死危险因素.结果 脑梗死组Lp（a）水平为（512±156） mg/L,检出率46.7％;无脑梗死组Lp（a）水平为（316±87） mg/L,检出率20.0％;对照组Lp（a）水平为（199±123） mg/L,检出率5.0％.三组之间Lp（a）水平及Lp（a）异常检出率差异有统计学意义（F=13.87,Х^2=29.394,P＜0.01）.脑梗死组常见脑梗死危险因素（如高血压、糖尿病、高脂血症、吸烟饮酒、肥胖或缺乏运动等）明显多于无脑梗死组（Х^2=15.523,P＜0.01）.结论 Lp（a）异常是脑梗死重要危险因素,普查Lp（a）对于脑梗死的一级、二级预防有重要意义,对于Lp（a）异常人群,应进一步进行各种可控性脑梗死危险因素的筛查与干预.

Objective To investigate the correlation among Lp （a）,cerebral infarction and carotid atherosclerosis.Methods 180 cases were equally divided into 3 groups （60 cases in each group）.The patients with both cerebral infarction and carotid atherosclerosis composed one group（＂cerebral infarction group＂ for short） ;the patients of carotid atherosclerosis which without cerebral infarction composed another group（＂no cerebral infarction＂ group for short） ;the control group composed with those who had neither cerebral infarction nor carotid atherosclerosis.The level,outlier detection rate about Lp（a） and usual risk factors of cerebral infarction were compared in this research.Results The level and detection rate of Lp（a） in the cerebral infarction group were （512 ± 156） mg/L and 46.7% ;the level and detection rate of Lp（a） in the no cerebral infarction group were （316 ± 87）mg/L and 20.0% ;the level and detection rate of Lp（a） in the control group were （199 ± 123） mg/L and 5.0%.The differences of the level and outlier detection rate of Lp（a） among the three group were significant（F=13.87,Х^2 =29.394,P 〈0.01）.Cerebral infarction patients had more usual risk factors of cerebral infarction （hypertension,diabetes,hyperlipemia,drinking,smoking,obesity and lack of exercise） than those who without cerebral infarction （Х^2 =15.523,P 〈 0.01）.Conclusion The abnormal of Lp（a） was an important risk factor of cerebral infarction.The general survey of Lp（a） was significant in the primary and secondary prevention of stroke.To the people whose assay of Lp（a） was abnormal,the control of governable risk factors of cerebral infarction should actively be carried out.