脂蛋白(a)与年轻人脑梗死的关系

背景一些流行病学和动物试验显示高脂蛋白(a)与动脉硬化和脑梗死相关,但是高脂蛋白(a)是否为年轻人脑梗死潜在的危险因素一直存在争议.目的调查脂蛋白(a)与年轻人脑梗死的关系.设计非随机对照的实验研究.地点和对象1995-01/2001-07湘雅医院神经内科住院的16～45岁的脑梗死患者.方法对年龄低于45岁的脑梗死患者及性别年龄匹配的对照组进行血清脂蛋白(a)和其他血脂成分的测定,询问其他可能的危险因素.主要观察指标血清脂蛋白(a)和其他血脂成分及其他可能的危险因素.结果脑卒中患者和对照组血清脂蛋白(a)水平差异未见显著性,脑卒中患者的三酰甘油显著高于对照组(P＜0.001),高脂蛋白(a)的OR值为1.547(95%CI0.601～3.982),而高三酰甘油血症和高血压的OR值分别为2.597(95%CI 1.149～5.381)和4.639(95%CI1.949～11.040).结论脂蛋白(a)可能不是年轻人脑梗死的危险因素,高三酰甘油血症和高血压则是重要的危险因素.

Relationship of lipoprotein (a) to cerebral infarction in young adults

BACKGROUND: The positive correlations between elevated lipoprotein(a)[Lp(a) ]and arteriosclerosis as well as cerebral infarction were shown by some epidemiological studies and animal experiments. However, elevated Lp(a) as a potential risk factor for cerebral infarction in young adults is still controversial.OBJECTIVE: To investigate the relationship between Lp(a) and cerebral infarction in young adults.DESIGN: A non-randomized case-control studySETTING, SUBJECTS and METHODS: The young adults(under 45 years) with cerebral infarction and the sex- and age-matched controls admitted into the Department of Neurology, Xianya Hospital, Central South University from January 1995 to July 2001. Levels of serum Lp(a) and serum lipids were measured, and other possible risk factors for cerebral infarction were recorded in the young adults(under 45 years) with cerebral infarction and in the sex-and age-matched controls.MAIN OUTCOME MEASURES: Levels of serum Lp(a) and lipids were measured and other possible risk factors for cerebral infarction were recorded.RESULTS: Serum Lp(a) values showed no significant difference between stroke patients and controls. However, the triglycerides(TG) level was significantly higher in patients with cerebral infarction than in controls( P ＜0. 001) . The odds radios for elevated Lp(a), hypertriglycerdemia and hypertension as risk factors for cerebral infarction in young patients were 1. 547[95% confidence interval(CI) 0. 601-3. 982], 2. 597(95%CI 1. 149-5.381), and 4. 639(95% CI 1. 949 - 11. 040) respectively.CONCLUSION: Lp(a) may not be a risk factor for cerebral infarction in young patients. Hypertriglycerdemia and hypertension are important risk factors in young adults with cerebral infarction.