血清血脂和胆红素水平与脑白质病变的相关性研究

目的探讨血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A-I (ApoA-I)、载脂蛋白B(ApoB)、脂蛋白(Lp)(a)、ApoB/ApoA-I、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平与脑白质病变(WML)的关系。方法纳入WML患者106例及对照组80例,根据Fazekas法将WML组分为Ⅰ级组、Ⅱ级组、Ⅲ级组。比较WML组与对照组之间临床资料、血脂及胆红素的水平的差异;采用多变量Logistic回归分析各血脂指标、胆红素与WML的关系;采用单因素方差分析各血脂指标、胆红素与WML严重程度的关系。结果与对照组比较,WML组年龄、高血压病、糖尿病、既往卒中的比例均明显升高(均P<0.05),WML组血清TG浓度明显升高,HDL、ApoA-I、TBIL、DBIL、IBIL水平均明显降低(均P<0.05)。多变量Logistic回归分析显示,血清HDL(OR=1.49,95%CI:1.02~2.16;P=0.044)、ApoA-I(OR=1.78,95%CI:1.25~2.64;P<0.001)、TBIL(OR=0.45,95%CI:0.22~0.63;P=0.007)、DBIL(OR=0.43,95%CI:0.24~0.82;P=0.034)、IBIL(OR=0.51,95%CI:0.31~0.73;P=0.008)是WML的独立危险因素,多因素Logistic回归分析显示,血清HDL、ApoA-I、TBIL、DBIL、IBIL水平与WML严重程度相关(均P<0.05)。结论血清HDL、ApoA-I、TBIL、DBIL、IBIL可能是WML的独立危险因素,且与WML严重程度相关。

Study on the correlation of serum lipids and bilirubin with white matter lesion

Objective To investigate the correlation of serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),apolipoprotein A-I(ApoA-I),apolipoprotein B(ApoB),lipoprotein(Lp)(a),ApoB/ApoA-I,total bilirubin(TBIL)direct bilirubin(DBIL)and indirect bilirubin(IBIL)levels with white matter lesion(WML).Methods One hundred and six patients with WML and 80 patients as control group were enrolled.The WML group was divided into gradeⅠ,gradeⅡand gradeⅢaccording to Fazekas methods.Clinical materials and levels of serum lipids and bilirubin were compared in WML group and control group.Multivariate logistic regression analysis was used to examine the relationship of serum lipids indices and the bilirubin with WML.One-way analysis of variance was used to examine the relationship of serum lipids indices and bilirubin with the severity of WML.Results Compared with control group,patients in WML group were older and showed significantly higher proportion of hypertention,diabetes,prior stroke(all P<0.05).Besides,serum TG concentrations were significantly rising and serum HDL,ApoA-I,TBIL,DBIL,IBIL levels were all significantly lower(all P<0.05).Multivariate Logistic regression analysis showed that serum HDL(OR=1.49,95%CI:1.02-2.16;P=0.044),ApoA-I(OR=1.78,95%CI:1.25-2.64;P<0.001),TBIL(OR=0.45,95%CI:0.22-0.63;P=0.007),DBIL(OR=0.43,95%CI:0.24-0.82;P=0.034),IBIL(OR=0.51,95%CI:0.31-0.73;P=0.008)were independent risk factors for WML.Multivariate Logistic regression analysis showed that serum HDL,ApoA-I,TBIL,DBIL,IBIL were correlated to the severity of WML(all P<0.05).Conclusion Serum HDL,ApoA-I,TBIL,DBIL,IBIL may be independent risk factors for WML and significantly correlated with the severity of WML.