脂质代谢异常与脑微出血的相关性在高血压脑微血管病评估中的价值

Role of correlation between lipid metabolism and cerebral microbleeds in the evaluation of hypertensive cerebral microvascular disease

目的:探讨高血压脑微出血(cerebral microbleeds,CMBs)患者与脂质代谢异常的相关性。方法:抽取50例单纯高血压患者、50例高血压CBMs患者和对照组66例,检测并比较3组TC,TG,HDL,LDL和A po-A,A po-B的水平,从而得出血脂水平与CMBs灶发病的关联性。患者均行T1加权成像(T1-weighted imaged,T1WI),T2加权成像(T2-weighted imaged,T2WI),弥散加权成像(diffusion weighted imaging,DWI)及磁敏感加权成像(susceptibility weighted imaging,SWI)扫描,统计CMBs发生率、数目、分布,分析CMBs与TC,TG,HDL,LDL和Apo-A,Apo-B的水平与影像学表现的相关性。结果:高血压病患者中CMBs病灶多分布在基底节-丘脑区域;年龄是影响CBMs的独立危险因素,高血压是首位危险因素,本高血压组患者的TC,TG,Apo-B水平较对照组显著增高,HDL显著减低;与对照组比较,高血压CBMs组A po-A水平降低,A po-B水平显著升高。TG在高血压CBMs组与对照组之间的差异最为显著,HDL水平和Apo-A与脑血管疾病的发生率呈负相关。CBMs组LDL和HDL的异常检出率高达31.76%和37.64%。结论:脂质代谢异常与CBMs的发生存在直接的相关性,高血压CBMs组脂质代谢异常检出率显著增高,脂质代谢异常在脑微血管疾病的发生中具有至关重要的作用,脂质代谢异常是CBMs发病的重要危险因素。

Objective： To investigate the correlation of abnormal lipid metabolism with cerebral microbleeds（CMBs） in hypertension patients. Methods： Fifty patients with simple hypertension patients, 50 patients with hypertension CMBs, and 66 normal patients as the control group were selected, TC, TG, HDL, LDL and Apo-A, Apo-B level were detected and compared, and further the relevance of the lipid levels and incidence of CMBs was analyzed. Patients were examined by T1-weighted imaged（T1 WI）, T2-weighted imaged（T2 WI）, diffusion weighted imaging（DWI） and susceptibility weighted imaging（SWI）. The incidence, number and distribution of CMBs were statistically analyzed, and the correlation between CMBs and TC, TG, HDL, LDL and Apo-A, Apo-B and imaging findings were analyzed. Results： CMBs lesions in patients with hypertension were mainly distributed in basal ganglia region. Age is the independent risk factors of cerebral hemorrhage, and hypertension is the first risk factors. Compared with the control group, the levels of TC, TG, Apo-B was significantly increased in the experimental group, HDL significantly reduced; Apo-A level reduced significantly, Apo-B level increased significantly in the hypertension with CMBs group. The abnormal detection rate of LDL and HDL in CMBs was as high as 31.76% and 37.64%. Conclusion： There is a direct correlation between serum lipid level and the occurrence of CMBs. Lipid metabolism is of great importance in the cerebral vascular diseases, and is a key risk factor of CMBs.