小而密低密度脂蛋白与脑卒中及其危险因素的关系  

Association of small, dense low density lipoprotein with stroke

作　　者：刘晓宁[1] 高岩[1] 叶珏[1] 汪道文[2] 廖玉华[3] 马爱群[4] 祝之明[5] 赵炳让[6] 赵继宗[7] 惠汝太 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院分子医学中心,北京100037 [2]华中科技大学同济医学院附属同济医院 [3]华中科技大学同济医学院附属协和医院 [4]西安医科大学第一附属医院 [5]第三军医大学大坪医院 [6]天津心血管病研究所 [7]北京天坛医院

出　　处：《中华医学杂志》2003年第22期1939-1942,共4页National Medical Journal of China

摘　　要：目的　探讨血浆小而密低密度脂蛋白 (sLDL)与脑卒中及其他危险因素的关系。方法采用 2 %～ 16 %的非变性梯度胶电泳检测经头颅CT和核磁共振检查证实的 2 0 4例脑卒中患者 (其中缺血性脑梗死 10 3例 ,腔隙性脑梗死 5 1例 ,脑出血 5 0例 )的血浆sLDL水平。对照 341例 ,性别、年龄匹配并经严格检查排除了脑卒中。观察各组间sLDL的变化及与预后的关系 ,对sLDL的影响因素采用多元逐步回归进行分析。结果　缺血性脑梗死组和腔隙性脑梗死组的血浆sLDL水平为 5 4 %±8%和 5 2 %± 7%明显高于对照组 (4 7%± 11% ,P <0 0 1～P <0 0 0 1) ;脑出血组的血浆sLDL水平(5 0 %± 9% )与对照组比较差异无显著意义 (P >0 0 5 )。多元逐步回归分析显示 ,危险因素中的甘油三酯、年龄、收缩压、高密度脂蛋白和低密度脂蛋白影响血浆sLDL水平 ,(P <0 0 5～ 0 0 1)。Logistic回归分析结果显示 ,sLDL >5 0 %者发生缺血性脑梗死的危险性增加 (OR值 =3 1,95 %可信区间1 6 4 9～ 5 6 91,P <0 0 0 1) ;sLDL异常与腔隙性脑梗死和脑出血的关系无显著统计学意义 (P >0 0 5 )。结论　sLDS水平与缺血性脑梗死的发生密切相关 ,可能是缺血性脑梗死新的危险因素。Objective To investigate the relationship between small, dense LDL(sLDL)and stroke in Chinese population. Methods The plasma level of sLDL was examined by 2%～16% nondenatured gradient gel electrophoresis in 204 patients with stroke, including 103 cases of ischemic cerebral infarction (ICI), 51 cases of lacunar infarction (LI), and 50 cases of subcortical hemorrhage (SH), and in 341 sex-and age-matched controls in China. Traditional risk factors for stroke were investigated as well. Results The plasma level of sLDL was significantly higher in patients with ICI and LI(54±8% and 52±7%)than in the controls(47±11%, both P< 0.01). However, the plasma sLDL of the CH patients was 50±9%, not significantly different from that of the controls (P>0.05). Multiple stepwise regression analysis showed that sLDL was significantly associated with systolic blood pressure, age, and the levels of triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (all P<0.05). Multivariate logistic regression analysis showed that those with sLDL>50% had increase of risk of ischemic cerebral infarction (OR=3.1, 95% CI 1.649～5.691, P<0.001) independent of other risk factors. The relationship between sLDL abnormality and LI and between sLDL abnormality and SH had no statistical significance (both P>0.05). Conclusion sLDL is significantly associated with ischemic cerebral infarction independent of other risk factors in Chinese population. sLDL may be a new marker for stroke at least in this Chinese population.

关 键 词：小而密低密度脂蛋白 脑卒中 危险因素 缺血性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]