老年急性脑梗塞患者血脂及血液流变学变化分析

目的研究老年急性脑梗塞患者血脂及血液流变学变化特点，并分析二者的相关性。方法７６例老年急性脑梗塞患者，测定全血粘度（ＢＶ）、血浆粘度（ＰＶ）、血小板聚集率（ＰＡｇｔ）、凝血酶时间（ＴＴ）、凝血酶原时间（ＰＴ）、白陶土部分凝血活酶时间（ＫＰＴＴ）、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、脂蛋白（ａ）［ＬＰ（ａ）］、载脂蛋白（Ａｐｏ）Ａ１、Ｂ、Ｅ。结果ＴＣ、ＴＧ、ＨＤＬ、ＬＤＬ、ＬＰ（ａ）、ＡｐｏＡ、ＡｐｏＢ各项在急性脑梗塞组与对照组之间比较均有显著性差异，ＢＶ、ＰＶ、ＰＡｇｔ均较对照组明显升高。ＢＶ及ＰＡｇｔ分别与ＴＣ、ＴＧ、ＬＤＬ呈显著正相关，与ＨＤＬ呈显著负相关。结论血脂异常、高凝与高粘度血症构成了老年脑梗塞发病的重要环节，血脂的变化与血液流变学及凝血的改变密切相关

Studies on serum lipids and blood rheology in elderly patients with acute cerebral infarction

Objective To study the significance of serum lipids and blood rheology in elderly patients with acute cerebral infarction. Methods The whole blood viscosity (BV),plasma viscosity(PV),platelet aggregation rate (PAgt),thrombin time (TT),prothrombin time (PT),kaolin partial thromboplastin time (KPTT),total cholesterol (TC),triglycerides (TG),high and low density lipoprotein cholesterol (HDL,LDL C),lipoprotein(a),and apolipoprotein (apo) A 1,B,E,etc.were analysed in 76 patients with acute cerebral infarction. Results Except Apo E,TT,PT,and KPTT,the mean values of other 10 paraneters showed statistically significant difference between the patients and the control group.BV and PAgt were positively correlated with TC,TG and LDL and negatively correlated with HDL. Conclusions High blood viscosity,hypercoagulability and hyperlipidemia were important factors related to the genesis of acute cerebral infarction in elderly patients.Changes in serum lipids are closely related with the alteration of blood rheology and coagulation.