中风急性期血清血脂脂蛋白亚组分与辨证关系

观察５５例急性期中风患者血清血脂及其亚组分胆固醇的变化，结果缺血性甘油三脂（ＴＧ）、胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－ｃ）、极密度脂蛋白胆固醇（ＶＬＤＬ－ｃ）明显高于出血性中风（Ｐ＜０．０５～０．００１）；高密度脂蛋白胆固醇（ＨＤＬ－ｃ）则出血性高于缺血性中风；但ＨＤＬ２－ｃ降低则是两者的共同特点。ＨＤＬ－ｃ、ＨＤＬ２－ｃ、ＨＤＬ２－ｃ／ＨＤＬ３－ｃ呈风火上扰＞痰瘀痹阻＞气虚血瘀；ＬＤＬ－ｃ、ＴＣ／ＨＤＬ－ｃ、ＴＣ－ＨＤＬ．ｃ／ＨＤＬ．ｃ、ＬＤＬ－ｃ／ＨＤＬ－ｃ则呈气虚血瘀＞痰瘀痹阻＞风火上扰。提示中风患者的防治，在调升ＨＤＬ－ｃ过程中，提高ＨＤＬ２－ｃ的临床意义更大；中风虚证患者动脉粥样硬化程度较实证者重，补虚化瘀是防治中风的重要法则，调治血脂代谢异常是化瘀通络的重要途径。

The relationship between the subconstituent of lipoprotein of blood lipid of serum in the acute period of apoplexy and ite differentiation

The serum lipid lipoprotein subfractions of 56 patients was observed.The results showed that the TG,TC,LDL-c,VLDL-c in ischemic stroke was significantly higher than those in hemorrhagic stroke( P <0.05￣0.01);While HDL-c in the latter was higher than that in the former.Both ischemic and hemorrhagic stroke had the lower HDL 2-c,The increase of HDL-c,HDL 2-c,HDL 2-c/HDL 3-c was in the folowing order:the type of wind-fire rise>of phlem-blood stasis stagnation>of qi deficiency and blood stasis.The lift of LDL-c,TC/HDL-c,TC-HDL-c/HDL-c,LDL-c/HDL-c was in the folowing order of the type of qi deficiency and blood stasis>of phlem-blood stasis stagnation>of wind-fire rise.The above results indicated that increasing HDL 2-c is more important during the prevention and treatment of stroke.The patients of stroke with deficiency syndrome had more severe atherosclerosis than those with excess syndrome.The regulation of blood lipid disorders is a main way of removing the blood stasis and smoothing the channels and collaterals.