中老年慢性脑缺血与血脂水平的相关性(英文)

Correlation between chronic ischemia of cerebral white matter and blood lipids levels in middle-aged and senile patients

目的分析脑白质慢性缺血与血脂各项水平的相关性,探讨血脂各项水平异常改变对脑白质慢性缺血的作用和意义。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)、三酰甘油(TG)、高密度脂蛋白(HDL)及其同工酶2(HDL2)和同工酶3(HDL3)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)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,ApoB100平均值高于正常组(t=0.71-1.558,P>0.05),HDL,HDL2,HDL3低于正常组(t=0.34-0.92,P>0.05),LDL高于正常组(t=2.72,P<0.05),ApoA1和A/B低于正常组(t=4.99,P<0.05)。皮层下动脉硬化性脑病组的HDL2低于正常组(t=2.16,P<0.05),而TC,TG,HDL,HDL3,LDL,ApoA1,ApoB100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(r=0.0238,P<0.05),而吸烟频数两组接近(r=1.4806,P>0.05)。逻辑回归提示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50岁以上血浆中LDL增高和HDL2,ApoA1,A/B降低可视为脑血管病的潜在危险因素,尤其是伴有高血压时。

Aim To investigate relationship between chronic ischemia of cerebral white matter and blood lipid level and explore the significance of blood lipid level changes in chronic ischemia of cerebral white cortex. Methods All patients were divided into three groups based on the magnetic resonance imaging, then TG,TC,HDL,HDL2,HDL3,LDL,ApoA1,ApoB100,A/B in serum as well as hypertension and smoking were analyzed by statistical method. Results Compared with normal group, TC,TG,ApoB100 of cerebral white matter chronic ischemia group was higher (t=0.71-1.558,P >0.05), HDL,HDL2,HDL3 , lower (t=0.34-0.92,P >0.05), LDL, higher (t=2.72,P< 0.05), ApoA1 and A/B, lower (t=4.99,P< 0.05), while HDL2 of subcortical arteriosclerotic encephalopathy group was lower (P< 0.05); TC,TG,HDL,HDL3,LDL,ApoA1,ApoB100 and A/B of subcortical arteriosclerotic encephalopathy was similar with that of cerebral white matter chronic ischemia group. Compared with normal group, the frequency of hypertension was significantly higher in the cerebral white matter chronic ischemia group (r=0.023 8,P< 0.05), while the frequency of cigarette smoking was similar between the two groups (r=1.480 6,P >0.05). Logistic regression analysis revealed that LDL and hypertension were independent risk factors for cerebral white matter chronic ischemia. Conclusion Patients with lower HDL2,ApoA1,A/B and higher LDL and aged above 50 years should be considered as risk population of potential cerebrovascualr disease, especially, those accompanied with hypertension.