血脂水平与脑卒中的关系研究

Study on the relationship between blood lipid level and stroke

目的探讨低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、载脂蛋白A1（ApoAI）、载脂蛋白B（ApoB）及脂蛋白（a）等血脂指标的异常与脑卒中发生的关系。方法选取2013年6月～2014年12月于我院住院治疗的200例脑卒中患者及同期200例健康体检者作为研究对象。根据脑卒中的分型将200例脑卒中患者分为脑梗死组（132例）和脑出血组（68例）。检测所有研究对象的血脂相关指标，并进行分析。结果脑梗死组与对照组相比较，TC、TG、LP（a）及ApoB水平显著升高，而HDL—C水平显著下降，差异有统计学意义（P〈0．05）；脑出血组与对照组比较TG及ApoB水平显著升高，而HDL—C水平显著下降，差异有统计学意义（P〈0．05）。排除高血压、糖尿病及吸烟等因素的影响，Logistic多因素回归分析结果显示：LP（a）、ApoB水平增加及HDL-C水平降低是脑梗死发生的危险因素；ApoB水平增加及HDL-C水平降低是脑出血发生的危险因素。结论血脂相关生化指标的变化在脑梗死和脑出血中有一定的差别，TC／HDL、LP（a）、ApoB水平增加是脑梗死发生的危险因素，ApoB水平增加是脑出血的危险因素，而HDL—C增加可能是脑卒中发病的保护因素。

Objective To investigate the relationship between the incidence of stroke and the abnormal blood lipid indexes such as low density lipoprotein （LDL-C）,high density lipoprotein （HDL-C）,apolipoprotein A1 （ApoA I）,apolipoprotein B （ApoB） and lipoprotein （a）. Methods 200 cases of stroke patients and 200 healthy volunteers of author＇s hospital were selected as the research object from June 2013 to December 2014.According to the classification of stroke,200 cases of stroke patients were divided into cerebral infarction group （132 cases） and cerebral hemorrhage group （68 cases）.The lipid related indexes of all subjects were detected and analyzed. Results The levels of TC,TG,LP （a） and ApoB in the cerebral infarction group were significantly higher than those in the control group,while HDL-C levels were significantly decreased in the cerebral infarction group,the difference was statistically significant （P 〈 0.05）.Compared with the control group,TG and ApoB levels in cerebral hemorrhage group were significantly increased, while HDL-C levels were significantly decreased,the difference was statistically significant （P ~ 0.05）.The effects of hypertension, diabetes and smoking and other factors were excluded.Logistic multiple regression analysis showed that LP （a）,ApoB and HDL-C were the risk factors of cerebral infarction,the increase of ApoB and decrease of HDL-C level were risk factors of cerebral hemorrhage. Conclusion The changes of blood lipid related biochemical indexes are different in cerebral infarction and cerebral hemorrhage.TC/HDL,LP （a） and ApoB levels are the risk factors for the occurrence of cerebral infarction.The increase of ApoB level is a risk factor for cerebral hemorrhage, and the increase of HDL-C maybe the protective factor of stroke.