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目的探讨老年脑梗死与血清胆红素、血脂的关系。方法对77例急性老年脑梗死患者测定其血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆固醇(TC)、甘油三酯(TG)、脂蛋白(a)[Lp(a)]水平,与健康对照组43例结果进行比较。老年脑梗死组再分为二个亚组:脑血栓形成组和腔隙性脑梗死组,二个亚组间再进行以上参数比较。结果脑梗死患者 TBIL、IBIL 水平明显低于正常对照组(P<0.05,P<0.01),而 Lp(a)明显高于正常对照组(P<0.01),两组之间 DBIL、TC、TG 差异无显著性。两亚组比较结果脑血栓形成组血清 TBIL、IBIL 水平显著低于腔隙性脑梗死组(P<0.05,P<0.01)。两组在合并高血压、糖尿病、非瓣膜性房颤等危险因素上无统计学意义的差异,DBIL、TC、TG、Lp(a)的差异亦无显著性。结论胆红素降低,Lp(a)水平升高与血栓性脑梗死有一定相关性,是预测脑梗死危险的重要指标。
Objective To investigate the relationship between senile cerebral infarction and serum bilirubin and blood lipid. Methods The serum levels of total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), total cholesterol (TC), triglyceride Protein (a) [Lp (a)] levels were compared with those in the healthy control group (43 cases). The elderly cerebral infarction group was further divided into two subgroups: cerebral thrombosis group and lacunar infarction group. The above two parameters were compared again. Results The levels of TBIL and IBIL in patients with cerebral infarction were significantly lower than those in normal controls (P <0.05, P <0.01), while Lp (a) was significantly higher than those in normal controls (P <0.01) No significant difference. Results of two subgroups: The levels of serum TBIL and IBIL in cerebral thrombosis group were significantly lower than those in lacunar infarction group (P <0.05, P <0.01). There was no significant difference between the two groups in risk factors such as hypertension, diabetes mellitus and nonvalvular atrial fibrillation. The differences of DBIL, TC, TG and Lp (a) were not significant. Conclusions The decrease of bilirubin and the increase of Lp (a) level have some correlation with thrombotic cerebral infarction. It is an important index to predict the risk of cerebral infarction.