中老年慢性脑缺血与血脂相关性探讨

Relationship Between the Cerebral White Matter Chronic Ischemia and Lipoprotein

目的 :分析脑白质慢性缺血与血脂各项水平的相关性。方法 :根据磁共振 (MR)表现对脑白质慢性缺血分组 ,然后分析各组之间血浆总胆固醇 (TC)、甘油三脂 (TG)、高密度脂蛋白 (HDL)及其同功酶2(HDL2 )和同功酶3(HDL3)、低密度脂蛋白 (LDL)、载脂蛋白A1(apoA1)、载脂蛋白B10 0 (apoB10 0 )及其两者比值 (A/B)以及高血压、吸烟的相关性。结果 :脑白质慢性缺血组的TC、TG、apoB10 0 平均值高于正常组 (P >0 0 5 ) ,HDL、HDL2 、HDL3低于正常组 (P >0 0 5 ) ) ,LDL高于正常组 (P <0 0 5 ) ,apoA1和A/B低于正常组(P <0 0 5 )。皮层下动脉硬化性脑病组的HDL2 低于正常组 (P <0 0 5 ) ,而TC、TG、HDL、HDL3、LDL、apoA1、apoB10 0 和A/B与脑白质慢性缺血组相似。高血压频数在脑白质慢性缺血组明显高于正常组 (P <0 0 5 ) ,而吸烟频数两组接近 (P >0 0 5 )。逻辑回归分析提示LDL和高血压是脑白质慢性缺血的单独致病危险因素。结论 :凡年龄在 5 0岁以上如血浆中LDL增高和HDL2 、apoA1、A/B降低可视为脑血管病的潜在危险因素 。

Objective:To investigate cerebral white matter chronic ischemia related with lipidemia.Methods:All patients were divided into three groups based on the magnetic resonance imaging,Then TG?TC?HDL?HDL 2?HDL 3?LDL?apoA 1?apoB 100 ?A/B in serum as well as hypertension and smoking were analyzed by statistical method.Results:Compared with normal group,TC?TG?apoB 100 of cerebral white matter chronic ischemia group was higher (P>0 05),HDL?HDL 2?HDL 3,lower(P>0 05),LDL higher,(P<0 05),apoA 1 and A/B,lower (P<0 05) while HDL 2 of subcortical arteriosclerotic encephalopathy group was lower(P<0 05)),TC?TG?HDL?HDL 3?LDL?apoA 1?apoB 100 and A/B of subcortical arteriosclerotic encephalopathy was similar with that of cerebral white matter chronic ischemia group.The frequency of hypertension was significantly higher in the cerebral while the frequency of cigarette smoking was similar between the two groups(P<0 05),white matter chronic ischemia group compared with normal group(P>0 05).Logistic regression analysis revealed that LDL and hypertension were independent risk factors for cerebral white matter chronic ischemia.Conclusion:If HDL 2?apoA 1?A/B was decreased and LDL was increased in serum of patients above 50 years old, the patients should be considered as risk population of potential cerebral vessels disease,especially,accompanied with hypertension.