脂蛋白(a)与年轻人脑梗死

Lipoprotein (a) and cerebral infarction in young adults

目的 研究脂蛋白 (a)与年轻人脑梗死发病的关系。方法 检测 90例发病年龄 16～ 4 5岁脑梗死患者脂蛋白 (a)与甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A Ⅰ、载脂蛋白B等 ,同时分析患者的高血压、吸烟、饮酒、卒中家族史等因素。结果 与对照组相比 ,脑梗死患者的脂蛋白 (a)无显著性增高。而甘油三酯、载脂蛋白B在脑梗死患者中却显著增高。相关分析显示 ,脂蛋白 (a)与血清总胆固醇和低密度脂蛋白胆固醇正相关 (P <0 .0 1)。logistic回归分析示高脂蛋白 (a)的相对危险度比值比 (OR)为 0 .74 ,95 %CI:0 .2 7～ 1.98。高甘油三酯对于脑梗死的OR值为 3.5 7,95 %CI :1.34～ 9.4 9;高血压对于脑梗死的OR值为 8.18,95 %CI:2 .5 4～ 2 6 .33;心脏病对于脑梗死的OR值为 8.5 1,其 95 %CI:2 .2 7～ 31.85 ;吸烟的OR值为 3.2 1,95 %CI:1.2 7～ 8.13。结论 脂蛋白 (a)可能不是年轻人脑梗死的危险因素。高甘油三酯、高血压、心脏病和吸烟是年轻人脑梗死重要的危险因素。

Objective To investigate the relation between lipoprotein (a) 〔LP(a)〕 and cerebral infarction in young adults. Methods Serum LP(a) of 90 young adults (age below 45 years) with cerebral infarction was measured. Serum lipids include triglyceride (TG), total cholesterol(TC), high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-Ⅰ(ApoA-Ⅰ) and apolipoprotein B(ApoB) were also measured. Other possible risk factors such as hypertension, smoking, drinking and family stroke history were reviewed. Results There was no significant difference of serum LP(a) value between stroke patients and controls. TG ( P < 0.01 ) and ApoB ( P < 0.01 ) values in patients with crerebral infarction were significant higher than those in controls. Lipoprotein(a) was correlated with total cholesterol and low density prolipotein cholesterol, with the values of correlation coefficient (r) 0.28 and 0.23 (both P < 0.01 ). After adjustment for age, sex, hypertension, smoking, drinking alcohol, family stroke history and other serum lipids, the odd radio for LP(a) and cerebral infarction was 0.74 (95% CI : 0.27- 1.98 ). The odd radio for elevated TG was 3.57 (95% CI : 1.34- 9.49 ); The odd radios for hypertension, heart diseases and smoking as risk factors for cerebral infarction in young patients showed as: hypertension OR = 8.18 ,95% CI : 2.54- 26.33 ; heart diseases: OR = 8.51 ,95% CI : 2.27- 31.85 ; smoking: OR = 3.21 ,95% CI : 1.27- 8.13 . Conclusion LP(a) might not be a risk factor for cerebral infarction in young patients while elevated triglyceride, hypertension,heart diseases and smoking were important risk factors in young adults with cerebral infarction.