老年再发脑梗死患者血脂及血液流变学变化

目的观察老年再发脑梗死患者血脂及血液流变学变化与初发者是否存在差异。方法选择老年再发脑梗死(第2次)患者(再发组)31例,首次脑梗死者(对照组)30例,另设健康组30例。再发组与对照组于入院第2天清晨空腹抽静脉血送检,采集前未用抗凝和溶栓药物。健康体检者清晨空腹采血1次。检测全血黏度(BV)、血浆粘度(PV)、血小板聚集率(Pagt)、凝血酶时间(TT)、凝血酶原时间(PT)、部分凝血酶时间(APTT),总胆固醇(PC),甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)。结果对照组与健康组比较,BV,PV,PAgt,TC,TG,HDL-C,LDL-C,Apo-A,Apo-B均存在明显差异(P<0.05或P<0.01),TT、PT、APTT无明显变化(P>0.05);再发组与对照组比较,BV,PV,Psgt,TC,TG,LDL-C,Apo-B均明显升高(P<0.05或P<0.01),HDL-C降低(P<0.05),Apo-A,TT,PT,APTT无明显变化(P>0.05)。结论高血脂与高凝、高黏度血症密切相关,均参与血栓形成。血脂及血液流变学部分参数升高或降低,是老年脑梗死的主要病理基础。

Changes in Blood Lipids and Hemorheology in the Elderly Patients with Recurrent Cerebral Infarction

Objective To observe the changes in blood lipids and hemorheology in the elderly patients with recurrent cerebral infarction.Methods Patients with cerebral infarction were devided into two groups,i.e.recurrent group(31) and initial group(30) acting as positive control,and another 30 healthy volunteers were enrolled in healthy group(30) as negative control.The first two groups were drawn venous blood next morning after being admitted to hospital,under the condition of empty stomach.No anticoagulants were administered before collecting the patients' blood.Volunteers of healthy group were also drawn venous blood in the morning before breakfast.The test items included blood viscosity(BV),plasma viscosity(PV),platelet adhension test(PAdT),thrombin time(TT),activated partial thromboplasin time(APTT),total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),apolipoprotein-A(Apo-A) and apolipoprotein-B(Apo-B).Results Between initial group and healthy group,there were significant differences in BV,PV,PadT,TC,TG,HDL-C,LDL-C,Apo-A and Apo-B (P<0.05 or P<0.01),and no significant differences in TT,PT and APTT(P>0.05).Furthermore,when compared between the recurrent group and initial group,there were significant increases in BV,PV,PadT,TC,TG,LDL-C and Apo-B(P<0.05 or P<0.01),and significant decrease in HLD-C(P<0.05).No significant changes in Apo-A,TT,PT and APTT were found(P>0.05).Conclusion Hyperlipemia is closely relative to blood coagulation and hyperviscosity that take part in thrombosis.Change in some parameters of blood lipids and hemorheology lays the key pathological foundation for the cerebral infarction in the elderly.