脑出血与8项血脂指标的关系探讨

测定了１２５例脑出血病人的血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白Ａ－１、Ｂ－１００（ＡｐｏＡ－１、ＡｐｏＢ－１００）、脂蛋白（ａ）［ＬＰ（ａ）］和氧化修饰低密度脂蛋白（ｏｘＬＤＬ）浓度。结果显示：与对照组比较，ＡｐｏＢ－１００、ｏｘＬＤＬ显著增高，ＨＤＬ、ＡｐｏＡ－１显著降低（Ｐ＜０．０１），ＬＤＬ明显降低（Ｐ＜０．０５），ＴＣ、ＴＧ、ＬＰ（ａ）无明显变化（Ｐ＞０．０５）。提示：血ＬＤＬ、ＡｐｏＢ－１００、ｏｘＬＤＬ浓度增高和ＨＤＬ、ＡｐｏＡ－１浓度降低与脑出血有一定的相关关系，可作为脑出血的危险因素。     

脑血管病脂蛋白（a）及其它血脂成分测定

本文报道４０例脑梗塞、３２例脑出血与５２例健康人对照的脂蛋白（ａ）［Ｌｐ（ａ）］、ＴＣ、ＴＧ、ＨＤＬ－Ｃ、ＨＤＬ２－Ｃ、ＨＤＬ３－Ｃ、ＡｐｏＡ、ＡｐｏＢ１００、ＡｐｏＡ１／ＡｐｏＢ１００、红细胞胆固醇（Ｅｒｙ－Ｃｈ）的测定结果，提示不同的脂代谢异常，导致不同的血管病理结局。特别指出，Ｌｐ（ａ）是反映脑梗塞脂代谢异常的突出指标，其对脑梗塞与脑出血的鉴别及其发病机理探讨有一定价值。     

脑血管病分类亚型与血脂关系的研究

目的：阐明血脂与脑血管病分类亚型的关系。方法：检测了２０８例脑血管病患者血清血脂７项指标含量。并与对照组５０例结果进行比较。ＴＧ、ＴＣ及ＨＤＬ－Ｃ采用酶法测定，ＡＰＯＡ－１、ＡＰＯＢ１００及ＬＰ（ａ）用免疫多点定标法测定，ＬＤＬ－Ｃ由ＴＧ、ＨＤＬ－Ｃ结果按公式计算。结果：脑梗塞（ＣＩ）患者ＴＧ、ＴＣ、ＬＤＬ－Ｃ、ＡＰＯ１００及ＬＰ（ａ）含量显著高于对照组，其ＴＧ、ＡＰＯＢ１００、含量也显著高于脑出血组，且ＬＰ（ａ）与ＡＰＯＢ１００，ＨＤＬ－Ｃ相关，复发ＣＩ亚组ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００含量，首发及老年ＣＩ亚组ＴＧ、ＴＣ、ＡＰＯＢ１００含量显著高于对照组。结论：血清ＴＧ、ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００及ＬＰ（ａ）水平升高是ＣＩ的危险因素，其中ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００对复发ＣＩ危险性大，而首发及老年ＣＩ可能主要与ＴＧ、ＴＣ、ＡＰＯＢ１００有关     

载脂蛋白（a）蛋白多态性与皮质脑梗塞相关性研究

目的在蛋白亚基水平上阐明载脂蛋白（ａ）［ａｐｏ（ａ）］多态性与脑梗塞的关系。方法８５名健康对照者和４２例皮质脑梗塞患者以ＥＬＩＳＡ法检测血Ｌｐ（ａ）水平、ＳＤＳ－ＰＡＧＥ／免疫印迹结合银染法检测ａｐｏ（ａ）蛋白大小多态性。结果得出脑梗塞患者血Ｌｐ（ａ）水平显著高于对照组；病人组低分子量ａｐｏ（ａ）表型频率明显高于对照组；但即使是相同ａｐｏ（ａ）表型个体间，病人的血Ｌｐ（ａ）水平仍显著高于对照者。结论研究在进一步证实高水平血Ｌｐ（ａ）是ＡＳ性脑梗塞危险因素的基础上，发现脑梗塞与决定Ｌｐ（ａ）高水平的低分子量ａｐｏ（ａ）表型密切关联，且提示除ａｐｏ（ａ）大小多态性外，尚有其它因素影响血Ｌｐ（ａ）水平。     

脑梗塞患者血清脂蛋白（a）含量的研究

为了阐明脂蛋白（ａ）水平增高是否为脑梗塞的重要危险因素及其与不同部位梗塞的关系，采用酶联免疫吸附试验检测了８７例脑梗塞患者血清脂蛋白（ａ）［Ｌｐ（ａ）］的含量，与对照组１１２例结果进行比较。结果显示，脑梗塞患者血清中Ｌｐ（ａ）含量明显高于对照组，Ｌｐ（ａ）增高的发生率在脑梗塞组（３３．３％）、深穿支动脉闭塞（ＰＡＯ）亚组（３２．３％）及皮层支动脉闭塞（ＣＡＯ）亚组（３６．４％）均明显高于对照组（５．４％）。血清Ｌｐ（ａ）水平增高的相对危险度比数比（ＯＲ）为８．８３。此外，９例有糖尿病病史患者的血清Ｌｐ（ａ）水平较７８例无糖尿病患者明显增高，血清Ｌｐ（ａ）水平与血糖呈正相关。结果表明，血清Ｌｐ（ａ）水平增高是脑梗塞及ＰＡＯ和ＣＡＯ亚组脑梗塞的重要危险因素。血糖或糖尿病史可能是影响血清Ｌｐ（ａ）水平的因素。     

脑梗死与脑出血患者血脂及脂蛋白含量的对比研究

目的：为了研究血脂与因管疾病的关系。方法：对２００例脑血管病患者血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白－Ａ１（ＡＰＯ－Ａ１）、载脂蛋白（ＡＰＯ－Ｂ）水平进行了检测,并与１００例年龄、性别,匹配的非脑血管对照组患者进行了对比分析。结果：脑梗死组血ＴＣ、ＴＧ、ＬＤＬ、ＡＰＯ－Ｂ含量显著高于脑出血组及非脑血管病对照组,ＡＰＯ－Ａ和ＨＤＬ脑梗死组显著     

载脂蛋白E基因多态性与动脉粥样硬化性脑梗塞的关系

目的探讨载脂蛋白（Ａｐｏ）Ｅ基因多态性与动脉粥样硬化性脑梗塞（ＡＣＩ）的关系。方法用聚合酶链反应（ＰＣＲ）技术检测了中国沈阳籍汉族健康人１００名和ＡＣＩ患者４７例的ＡｐｏＥ基因ＨｈａＩ多态性及血脂、脂蛋白含量。结果ＡＣＩ患者组ＡｐｏＥ基因型ε３／４的频率为２７．７％，明显高于对照组。ＡＣＩ患者组血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、脂蛋白（ａ）［Ｌｐ（ａ）］明显高于对照组，ＡｐｏＡＩ则明显低于对照组。对照组和ＡＣＩ患者组中ＡｐｏＥ基因型ε３／４的血清ＬＤＬ－Ｃ均显著高于ε３／３。结论ＡｐｏＥ基因型ε３／４与ＡＣＩ的发生相关；等位基因ε４可能是ＡＣＩ的一种遗传易感性因子。     

氧化低密度脂蛋白和一氧化氮的相互作用及其在缺血性脑卒中发病中的作用

目的研究急性缺血性脑卒中患者血浆氧化低密度脂蛋白（ｏｘＬＤＬ）与一氧化氮（ＮＯ）的关系及它们在缺血性脑卒中发病机制中的作用。方法测定４５名健康体检者、２０例动脉硬化患者和７５例急性缺血性脑卒中患者血浆ＬＤＬ及体外氧化获得的ｏｘＬＤＬ对血小板聚集功能和ＮＯ水平的影响。结果动脉硬化和脑卒中患者血浆ｏｘＬＤＬ值均明显升高,提示血浆ＬＤＬ及ｏｘＬＤＬ对血小板聚集有明显的促进作用,同时降低ＮＯ水平;血小板聚集的增强和ｏｘＬＤＬ呈正相关,和ＮＯ呈负相关,而和ＬＤＬ水平无相关性。结论脑卒中和动脉硬化患者ＬＤＬ对氧化修饰的易感性增加,氧化修饰的ＬＤＬ通过激活血小板、灭活ＮＯ而促进动脉粥样硬化,易致血栓形成。因此,抗氧化治疗在脑卒中和动脉硬化的防治中有重要意义。     

脂蛋白(a)在不同部位脑梗死病人中的诊断价值

目的：探讨高浓度Ｌｐ（ａ）在不同部位脑梗死的关系。方法：采用单向火箭免疫电泳法检测６０例健康人和６６例脑梗死患者血清Ｌｐ（ａ）的含量。结果：脑梗 皮质动脉区脑梗死组Ｌｐ（ａ）水平显著性地高于对照组，其中穿通动脉区脑梗死组Ｌｐ（ａ）含量明显低于皮质动脉区脑梗死组，而与正常对照组无显著性差异，结论：血清Ｌｐ（ａ）浓度增高是脑梗死重要的危险因素，其中可能在在皮质动脉区脑梗死发病中起到独立的作用。     

不同类型脑梗塞患者血脂蛋白（α）水平分析

本研究对３０例皮质动脉区脑梗塞（ＣＡＣＩ）、３２例穿通动脉区脑梗塞（ＰＡＣＩ）、３２例原发性高血压病患者及年龄性别与ＣＡＣＩ患者匹配的无心脑血管病等的对照者以ＥＬＩＳＡ法测定血清Ｌｐ（α）水平。结果显示对照者与高血压病者血Ｌｐ（α）均值相近，而ＣＡＣＩ患者血Ｌｐ（α）均值显著高于对照者，ＰＡＣＩ患者其值虽亦高于对照者，但其中高于对照者血Ｌｐ（α）水平第９５％位数值２８０．３２ｍｇ／Ｌ者并不多于对照组；且脑梗塞患者发病２周内血Ｌｐ（α）水平相对稳定。提示高水平血Ｌｐ（α）是动脉粥样硬化（ＡＳ）性脑梗塞的危险因素，而非脑梗塞发生的致病因素。     

脑血管疾病患者血浆血脂类生化指标的相关性分析

目的分析脑出血和脑梗死患者血浆脂蛋白、总胆固醇、甘油三酯、同型半胱氨酸(Hcy)含量的变化,为脑血管疾病的诊断和干预提供依据。方法选取郑州大学第五附属医院2015-06—2016-06收治的94例脑血管疾病患者为观察组并选取同期健康体检的志愿者92例为对照组,观察组依据疾病类型分为观察组Ⅰ(脑出血患者,n=48)和观察组Ⅱ(脑梗死患者,n=46),采用全自动生化分析仪和配套试剂检测所有患者血浆脂蛋白、总胆固醇、甘油三酯、同型半胱氨酸含量,并进行对比分析。结果观察组脂蛋白、总胆固醇、甘油三酯、同型半胱氨酸含量高于对照组,差异有统计学意义(P0.05),观察组Ⅱ脂蛋白、同型半胱氨酸含量高于观察组Ⅰ,差异有统计学意义(P0.05)。结论脑血管疾病患者脂蛋白、总胆固醇、同型半胱氨酸含量增高,脂蛋白及同型半胱氨酸含量与脑梗死的发生密切相关。     

Elevated plasma levels of lipoprotein(a) in psychiatric patients: a possible contribution to increased vascular risk.

An increased incidence of adverse cardiovascular events has been reported in psychiatric patients, but the exact mechanisms underlying this association are still uncertain. Elevated plasma level of lipoprotein(a) [Lp(a)] is an independent risk factor for atherothrombotic disease in the general population. To study the implications of Lp(a) in psychiatric patients, we measured the plasma levels of Lp(a) in 74 patients with psychiatric disorders (39 schizophrenia, 10 major depression, 13 bipolar disorder and 12 personality disorder) and 74 healthy controls. The Lp(a) levels of the patient groups with schizophrenia, major depression and bipolar disorder were significantly higher than that of the control group. The median Lp(a) value of these diagnostic groups was comparable with those reported in patients with prior atherothrombotic events. On the other hand, no differences were found among personality disorder and controls. Our findings suggest that the elevation of plasma Lp(a) may contribute to increased cardiovascular risk in several patients with psychiatric disorders.     

脑血管病患者神经肽Y的临床研究

目的观察脑出血（CH）、脑梗死（CI）、蛛网膜下腔出血（SAH）患者神经肽Y（NPY）水平动态变化及其临床意义。方法选择脑血管病（CVD）患者138例,其中CH组46例,CI组62例,SAH组30例。用放免法检测血浆NPY浓度。结果CI组、CH组、SAH组NPY水平显著高于对照组,于发病后24h内均显著升高,1～3d或4～7d达高峰,8～15d开始下降,15d后仍在较高水平;重型与大灶组显著高于中、轻型与小灶组;发病积分≥6分组显著高于<6分组,伴高血压组显著高于不伴高血压;伴消化道出血组显著高于不伴消化道出血组。结论NPY参与了CVD及其伴发病的病理生理过程。     

脑血管病患者胃动素的临床研究

目的：观察脑出血（ＣＨ）、脑梗死（ＣＩ）、蛛网膜下腔出血（ＳＡＨ）患者胃动素（ＭＴＬ）水平的动态变化及其临床意义。方法：选择脑血管病（ＣＶＤ）患者１３８例。用放免法检测血浆ＭＴＬ浓度。结果：ＣＶＤ各组ＭＴＬ水平显著高于对照组,发病２４ｈ内即升高;ＣＩ组、ＳＡＨ组４～７ｄ达峰水平,ＣＨ组１～３ｄ达峰水平,８～１５ｄ降低,１５ｄ仍在较高水平;随病情严重程度的加重ＭＴＬ水平升高;高血糖组显著高于正常血糖     

Association of levels of lipoprotein (a) and other lipoproteins with cerebrovascular disease in the Turkish population

Lipoprotein (a) [Lp (a)] is a cholesterol-rich lipoprotein that structurally resembles the low density lipoprotein cholesterol (LDL-C) particles, but contains a molecule of apolipoprotein (a) attached to apolipoprotein B by disulfide bond. Because of the fact that high plasma levels of Lp (a) have been shown to be associated with cerebrovascular disease (CVD), we determined plasma Lp (a) levels in CVD for the Turkish population, and compared them with previous findings of some developed countries. Plasma Lp (a) levels were evaluated in CVD and control groups. The mean plasma Lp (a) levels in the CVD group was found to be approximately two-fold higher than that of the control group (0.21 g/1 vs 0.38 g/1). Also, it was found to be higher than the mean levels of CVD group in the other populations described in previous reports. But CVD prevalence in the Turkish population is lower than in those of developed countries, especially United States and Japan. Therefore, we believe that each of those populations should determine their plasma Lp (a) levels to observe the risk for CVD.     

Lp(a) lipoprotein in cerebrovascular disease and dementia

Lp(a) lipoprotein has been considered an independent risk factor in the development of coronary heart disease (CHD). We examined the role of Lp(a) in patients with cerebrovascular disease (CVD) and those with dementia. The Lp(a) concentration in patients with CHD, those with cerebral infarction due to a large artery occlusion and those with vascular dementia (VD) was significantly higher than that of age-matched control subjects. However, the Lp(a) concentration was not high in cerebral infarction due to a small artery occlusion, intracerebral hemorrhage and dementia of the Alzheimer type (DAT). The present results suggest that Lp(a) should cause VD as well as CVD, and that Lp(a) should be one of the indicators that distinguish VD from DAT.     

糖尿病性脑梗死与非糖尿病性脑梗死患者血清脂蛋白(a)水平的比较

目的 比较糖尿病性脑梗死与非糖尿病性脑梗死患者血清脂蛋白（a）水平，探讨Lp（a）糖尿病及脑梗死之间的关系。方法 采用ELISA双抗体夹心法检测脑梗死患者的血清Lp（a）水平，并分别比较脑梗死组与对照组、糖尿病性脑梗死组与非糖尿病性脑梗死组、动脉粥样硬化性脑梗死与腔隙性脑梗死组之间Lp（a）水平变化。结果 脑梗死患组与对照组比较，脂蛋白（a）血浆浓度明显增高；糖尿病性脑梗死组与非糖尿病性脑梗死组脂蛋白（a）水平、动脉粥样硬化性脑梗死与腔隙性脑梗死组之间Lp（a）水平差异均具有显著性意义（P〈0．01）。结论 Lp（a）是缺血性脑卒中的一个危险因素，在动脉粥样硬化斑块的形成中起重要作用，脑梗死患者Lp（a）与糖尿病有一定的关联性。     

Lp(a) Lipoprotein in Cerebrovascular Disease and Dementia

Abstract: Lp(a) lipoprotein has been considered an independent risk factor in the development of coronary heart disease (CHD). We examined the role of Lp(a) in patients with cerebrovascular disease (CVD) and those with dementia.
The Lp(a) concentration in patients with CHD, those with cerebral infarction due to a large artery occlusion and those with vascular dementia (VD) was significantly higher than that of age-matched control subjects. However, the Lp(a) concentration was not high in cerebral infarction due to a small artery occlusion, intracerebral hemorrhage and dementia of the Alzheimer type (DAT).
The present results suggest that Lp(a) should cause VD as well as CVD, and that Lp(a) should be one of the indicators that distinguish VD from DAT.     

LIPOPROTEIN(a) CONCENTRATION AND MOLECULAR WEIGHT OF APOLIPOPROTEIN(a) IN PATIENTS WITH CEREBROVASCULAR DISEASE AND DIABETES MELLITUS

Plasma lipoprotein(a) [Lp(a)] concentrations are genetically determined, and hyper-Lp(a)-emia is an independent risk factor for atherosclerosis and thrombosis. To study the implications of Lp(a) in cerebrovascular disease (CVD) and diabetes mellitus (DM), we examined plasma Lp(a) levels and molecular weights of apolipoprotein(a) [apo(a)] in 118 patients with CVD, and 125 cases with DM. Although mean Lp(a) concentrations were higher in those cases with atherothrombotic brain infarction than in those with brain hemorrhage and lacunar infarction, the difference was not statistically significant. Lp(a) levels were significantly higher in the DM cases treated with insulin and in those treated with oral hypoglycemic agents than in those on diet therapy alone, suggesting that insulin and oral agents modulate apo(a) expression. Lp(a) concentrations correlated significantly with the low-molecular-weight isoforms of apo(a) in all CVD and DM groups. © 1997 Elsevier Science Ltd     

脑血管病患者CGRP的临床研究

目的：1．观察脑出血（CH）、脑梗死（CI）患者降钙素基因相关肽（CGRP）水平改变及其动态变化;2观察CH、CI病情、病灶大小与CGRP水平变化的关系;3．研究CGRP与脑血管病（CVI））伴发疾病的关系;4．探讨CGRP参与各型CVD及其伴发病中的病理生理机制及其临床意义,并探讨其异常分泌的可能机制;5探讨CVD防治的新途径。方法：选择CVD1I8例,其中CH组46例．CI组62例。用放免法检测血浆CGRP浓度。结果：1．CI组CGRP的变化：显著低于对照组,发病24h内即显著降低,2～3d与4～7d则进一步降低,8～15d开始升高,15d后逐渐升至正常水平。伴发病积分＞6分组显著低于＜6分组,高血糖组显著低于正常血糖组。2．CH组CGRP的变化：显著低于对照组．发病24h内即显著降低,2～3d与4～7d进一步降低,8～15d有所升高,15d后进一步升高,仍低于正常水平。随病情加重,脑出血量增加,CGRP水平明显降低。结论：l．CICH患者存在CBRP分泌异常,CGRP参与了CVD的病理生理过程。2．各组CVD、CGRP动态检测可作为病情严重程度、病灶大小及预后的重要指标。3．本研究结果提示,调整CGRP的分泌将有助于改善各组CVD的预后．并为应用CGRP治疗缺血性脑损伤提供了广阔的前景。