缺血性脑卒中与血脂水平关系的初步分析

目的研究血脂异常与缺血性脑卒中及其各亚型的关系。方法收集516例缺血性脑卒中患者及131例非缺血性卒中对照组个体的血脂情况，包括血总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）等指标，对其进行统计分析比较。并将其中131例缺血性脑卒中患者根据TOAST分型标准进行分型，将各亚组的血脂水平与对照组再进行比较。结果缺血性脑卒中组的HDL水平明显低于对照组，TC／HDL比值明显高于较对照组。其余血脂成分，包括TC、TG、LDL则未发现存在显著差异。亚组比较中，大动脉粥样硬化性卒中（LAA）组、心源性脑栓塞（CE）组、小动脉闭塞性卒中或腔隙性卒中（SAO）组的HDL水平明显低干对照组，而他们的TC／HDL比值则明显高于对照。其余血脂成分比较未见统计学差异。其他原因卒中（SOE）及不明原因卒中（SUE）均显示与血脂各成分无相关性。结论HDL在缺血性脑卒中患者明显降低，其保护因素降低可能是卒中发生的原因之一。TC／HDL比值可作为衡量血脂异常与缺血性卒中关系的指标之一。需要进一步进行基于卒中分型基础上的更大样本量的研究。

An evaluation of association between ischemic stroke and lipides levels

Objective To evaluate the association of lipids and the risk of ischemic stroke and its subtypes. Methods We evaluated the levels of total cholesteroi（TC）,triglycerides（TG）, low density lipoprotein（LDL） and high density lipoproteins（HDL） in 516 patients with ischemic stroke and 131 controls. With TOAST criteria, we also evaluated lipids in stroke subtypes. Results Compared with controls, the HDL level was significantly lower and the TC/HDL ratio was significantly higher in stroke group. The differences among other components of lipids were not significant. The level of HDL was significantly lower in large artery atherosclerosis （LAA）, cardioaortic embolism （CE） and small artery occlusion （SAO）. The TC/HDL ratio in them was significantly higher than that of controls. Conclusion The reduced protection resulted from the lower level of HDL may be one of the masons for the attack of ischemic stroke. The TC/HDL ratio can be taken as one of the measures for the interrelationship between abnormal lipids and ischemic stroke. Further researches on lipids and stroke should be conducted with a larger pool of samples on the basis of stroke classifications.