青壮年男性截瘫患者血脂代谢的观察

目的 通过流行病学调查来了解青壮年男性截瘫患者血脂代谢水平特点,探讨双下肢运动功能缺失对男性血脂的影响.方法 对中国康复研究中心2004年至2008年因截瘫入院进行康复治疗的男性患者进行入院状态调查.人选要求:①病史明确(T2～L5平面脊髓损伤致双下肢瘫痪);②资料完整;③18周岁≤年龄≤60岁;④非脑卒中患者.共650例患者入选,对血脂指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]进行分析.结果 青壮年男性截瘫患者TG、TC水平显著高于全国男性平均水平,分别达到1.72 mmol/L和4.42 mmol/L;HDL水平显著低于全国男性平均水平,只有0.99 mmol/L;LDL平均水平与全国男性平均水平差异无统计学意义(P＞0.05).年龄与TG、TC、LDL显著正相关(分别为r=0.202,P＜0.01;r=0.213,P＜0.01;r=0.144,P＜0.01);年龄与HDL无显著相关;病程与LDL负相关(r=-0.082,P＜0.05),与HDL正相关(r=0.163,P＜0.01).血脂异常发生率66.8%,低HDL血症发生率63.5%.结论 青壮年男性截瘫患者的血脂代谢异常主要表现为HDL水平显著降低,HDL水平与病程正相关,可能与上肢运动代偿性增加有关.对这些人群的心血管健康隐患,有必要予以深切关注和尽早干预.

Abstract：

Objective To investigate the serum lipids levels of Chinese men with chronic paraplegia.Methods A total of 650 male paraplegics admitted to the China Rehabilitation Research Center (CRRC) for rehabilitation therapy from Jan 2004-Dec 2008 were investigated. The inclusion criteria were a definite paraplegic history (T2-L5 spinal cord injury); complete data; age 18-60 years; and no history of stroke. TG, TC, LDL and HDL serum lipid profiles were studied. Results These male paraplegics showed significantly higher mean TG and TC levels and lower mean HDL levels than the nation-wide averages for similar males ( TG 1.72 mmol/L vs. 1.36 mmol/L; TC4.42 mmol/L vs. 4.30 mmoL/L; HDL 0.99 mmol/L vs. 1.18 mmol/L). No difference in average LDL levels was found. TG, TC and LDL levels were correlated positively with age, but HDL was not. Duration of paraplegia correlated positively with HDL levels, but negatively with LDL. The prevalence of dyslipidemia was 67% , and the prevalence of low HDL was 64%. Conclusions The serum lipid profiles of the young male paraplegics showed a high prevalence of dislipidemia, significantly low HDL levels with a high prevalence of low HDL, and no correlation with age. TG, TC and LDL levels increased with age. The duration of paraplegia was correlated positively with HDL but negatively with LDL, probably due to increased exercise of the upper limbs.

Serum lipid profiles of Chinese men with chronic paraplegia