脑梗死与颈动脉斑块及血脂的相关性分析

目的:探讨脑梗死与颈动脉粥样硬化斑块及血脂代谢的关系。方法:对70例脑梗死患者(病例组)和38名正常体检者(对照组)行动脉彩色多普勒超声检查颈动脉硬化斑块,同时检测两组的血浆脂质代谢水平,包括总胆固醇(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)和脂蛋白(a)[LP(a)]。结果:病例组70例,斑块检出率70.0%(49/70),明显高于对照组的18.4%(7/38)(P<0.01);同时比较两组的TC、TG、HDL-C、LDL-C和LP(a)水平。脑梗死组血浆TC、LDL-C水平高于对照组(P<0.05),其它血脂指标无显著差异,而LDL-C/HDL-C比值在两组有明显差异(P<0.01)。将病例组按颈动脉斑块的有无分为脑梗死 斑块组(CI P)、脑梗死无斑块组(CI-P),发现CI P组LDL- C、HDL-C较CI-P组分别有升高、下降趋势,但各自差异无显著统计学意义,而研究LDL-C/HDL-C比值则CI P组明显高于CI-P组(P<0.05)。结论:脑梗死发病与颈动脉粥样硬化斑块密切相关;高血浆TC、LDL-C水平促发脑梗死的发生,分析LDL-C/HDL-C水平与脑梗死的发生有很大的相关性,尤其对有颈动脉粥样斑块的脑梗死有重要意义。

Study on the correlation among cerebral infarction, carotid atherosclerotic plaque and plasma lipoprotein

Objective:To study the correlation among cerebral infarction,carotid atherosclerotic plaque and plasma lipopro- tein.Methods:The carotid atherosclerotic plaque was performed with color doppler ultrasonography and the plasma lipoprotein was measured in 70 patients with cerebral infarction (CI) and 38 cases of controls matched in sex and age.CI patients were divided into two groups:cerebral infarction with plaque group (CI P,n=49) and cerebral infarction without plaque group (CI- P,n=21).Results:(1) The incidence of carotid atherosclerotic plaque was 70.0% in CI and 18.4% in controls.There was significant difference (P<0.01) between two groups;(2) Plasma total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were higher in CI than in controls(P<0.05) and LDL-C/HDL-C was significantly higher in CI group(P<0.01);(3)LDL-C and HDL-C had more increasing and decreasing tendency in CI P than in CI-P respectively,but no statistical difference was found.The level of LDL-C/HDL-C was analysed,and it was significantly higher in CI P than in CI-P (P<0.05).Conclusion: There is a close correlation between carotid atherosclerotic plaque and cerebral infarction.High plasma TC and LDL-C contribute to the currence of CI.Analysis of LDL-C/HDL-C is very helpful to CI diagnosis,especially to CI with carotid atherosclerotic plaque.