缺血性脑血管病患者脂蛋白a与颈动脉内膜增厚及斑块形成相关性研究

Correlation between lipoprotein(a) and carotid intimal thickening and plaque formation in patients with ischemic cerebrovascular disease

目的:探讨缺血性脑血管病患者脂蛋白a[Lp(a)]与颈动脉内膜增厚及斑块形成相关性。方法回顾性分析缺血性脑血管病患者临床资料,按颈动脉彩超结果,将患者分为内膜正常组,内膜增厚组及斑块形成组;同时测定患者血脂组分(LDL,HDL,TG,Lp(a))及其他血管性危险因素。结果:缺血性脑血管病患者Lp(a),LDL,TG水平高于常规体检者,HDL水平较之降低,差异有统计学意义(P<0.05);内膜增厚组及斑块形成组LDL,Lp(a),HDL水平高于内膜正常组,差异有统计学意义(P<0.05);斑块形成组LDL,TG水平高于内膜增厚组及内膜正常组,差异均有统计学意义(P<0.05);内膜增厚组与斑块形成组组间Lp(a),HDL水平比较,差异无统计学意义(P>0.05)。经多因素logistic回归分析,Lp(a)是颈动脉硬化的独立危险因素。结论:血脂不同组分在颈动脉内膜增厚及斑块形成的不同阶段可能发挥不同作用;LP(a)在增厚期作用相对更显著。

Objective：To explore the correlation between lipoprotein（a） and carotid intimal thickening and plaque formation in patients with ischemic cerebrovascular disease. Methods ： Clinical data of patients with isehemic cerebrovascular disease were collected and analyzed retrospectively. According to color Doppler ultrasound examination results, the patients were divided into a normal group, an intimal thickening group and a plaque formation group. LDL, HDL, TG, Lp（a） and other vascular risk factors were tested in the patients. Results：Lp （ a ） , LDL, and TG levels in the patients with isehemic eerebrovascular disease were higher than those in the healthy subjects, and the HDL level was lower. LDL, Lp（a） , and HDL levels were higher in the carotid intimal thickening and plaque formation groups than in the normal group. LDL and TG levels in the plaque formation group were higher than those in the intimal thickening and normal groups. The difference was statistically significant. Lp（a） and HDL levels were different between the carotid intimal thickening and plaque formation groups, but there was no significant difference. LP（ a ） was an independent risk factor for carotid atherosclerosis by logistic regression analysis. Conclusion： Different components of lipids may play a different role in different stages of carotid intimal thickening and plaque formation. Lp（a） is more significant in the early stage.