脑梗死患者伴脑白质疏松症的相关危险因素及与脂蛋白相关磷脂酶A_2相关性的研究  

The risk factors and the correlation of lipoprotein associated phospholipase A_2(Lp-PLA_2)in patients of cerebral infarction with leukoaraiosis(LA)

作　　者：贵永堃[1] 吕晓红[1] 

机构地区：[1]吉林大学白求恩第一医院神经内科,吉林长春130021

出　　处：《中风与神经疾病杂志》2011年第11期980-984,共5页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨脑梗死患者伴脑白质疏松症(LA)的相关危险因素及与脂蛋白相关磷脂酶A2(LP-PLA2)的相关性。方法选取178例脑梗死患者,依其影像学表现将其分为脑梗死合并LA组(83例)和脑梗死不合并LA组(95例),对比分析两组的Lp-PLA2含量以及临床、辅助检查指标。结果 (1)脑梗死患者共178例,LA的发病率46.63%。(2)单因素分析结果显示:在LA例组和无LA组年龄、Lp-PLA2、高血压病史及腔隙性脑梗死之间的差异具有统计学意义;多因素Logistic回归分析结果筛选出3个具有统计学意义的指标:Lp-PLA2、年龄和腔隙性脑梗死。(3)性别、糖尿病史、高脂血症、吸烟史、饮酒史、冠心病史及脑血管狭窄发生率在LA组和无LA组的差异无统计学意义。(4)两组高脂血症患者的LDL、甘油三脂、胆固醇水平及两组糖尿病患者的空腹血糖值差异无统计学意义,脑血管狭窄分为单纯前循环病变、单纯后循环病变及前后循环均有病变后,两组间构成比差异无统计学意义。结论年龄、Lp-PLA2、腔隙性脑梗死是LA独立的危险因素。颅内外大血管狭窄与LA无确切的相关性。高血压是LA重要的危险因素。糖尿病、高血脂、吸烟史、饮酒史、冠心病史是LA和缺血性脑卒中的共同危险因素。Objective To study the related risk factors and the correlation of lipoprotein associated phospholipase A2（Lp-PLA2）in patients of cerebral infarction with leukoaraiosis（LA）.Methods 178 cerebral infarction patients were divided into a cerebral infarction with leukoaraiosis group（LA group）and a cerebral infarction without leukoaraiosis group（no LA group）.Their Lp-PLA2 levels and clinical,laboratory examinations were compared.Results The incidence of LA was 46.63%in 178 patients with cerebral infarction.Univariate analysis showed there were significant differences between LA group and no LA group in age,Lp-PLA2,history of hypertension and lacunar infarction.After the logistic multivariate regression,We screened out three indicators with statistical significance：Lp-PLA2,age and lacunar infarction.There was no significant difference between LA group and no LA group in gender,diabetes,hyperlipidemia,the history of smoking and alcohol consumption,coronary heart disease and cerebral vascular stenosis.There was no significant difference between two groups in low-density lipoprotein cholesterol,triglycerides,cholesterol of hyperlipidemia and fasting glucose of diabetes.After cerebral vascular stenosis was divided into anterior circulation disease,posterior circulation disease,and both of them,the proportion had no significant difference between two groups.Conclusion Lp-PLA2 and lacunar infarction is an independent risk factor for LA.There is a lack of relationship between cerebral large artery stenosis and LA.Hypertension is an important risk factor for LA.The risk factors in LA and the ischemic stroke are the same,including diabetes,hyperlipidemia,the history of smoking and alcohol consumption and coronary heart disease.

关 键 词：人血浆脂蛋白相关磷脂酶A2 脑白质疏松 脑梗死 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]