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目的分析脑白质慢性缺血与血脂各项水平的相关性,探讨血脂各项水平异常改变对脑白质慢性缺血的作用和意义。方法根据磁共振(MR)表现对脑白质慢性缺血分组,然后分析各组之间血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)及其同工酶2(HDL2)和同工酶3(HDL3)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)及其两者比值(A/B)以及高血压、吸烟的相关性。结果脑白质慢性缺血组的TC,TG,ApoB100平均值高于正常组(t=0.71-1.558,P>0.05),HDL,HDL2,HDL3低于正常组(t=0.34-0.92,P>0.05),LDL高于正常组(t=2.72,P<0.05),ApoA1和A/B低于正常组(t=4.99,P<0.05)。皮层下动脉硬化性脑病组的HDL2低于正常组(t=2.16,P<0.05),而TC,TG,HDL,HDL3,LDL,ApoA1,ApoB100和A/B与脑白质慢性缺血组相似。高血压频数在脑白质慢性缺血组明显高于正常组(r=0.0238,P<0.05),而吸烟频数两组接近(r=1.4806,P>0.05)。逻辑回归提示LDL和高血压是脑白质慢性缺血的单独致病危险因素。结论凡年龄在50岁以上血浆中LDL增高和HDL2,ApoA1,A/B降低可视为脑血管病的潜在危险因素,尤其是伴有高血压时。
Objective To analyze the correlation between white matter chronic ischemia and serum lipids and to explore the effect and significance of abnormal changes of blood lipid levels on chronic white matter ischemia. Methods According to the MR findings, we divided the patients with chronic white matter ischemia into two groups according to the different levels of plasma total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and its isoenzyme 2 HDL2, HDL3, LDL, ApoA1, ApoB100 and their ratios (A / B), as well as hypertension, smoking Correlation. Results The mean levels of TC, TG and ApoB100 in white matter with chronic cerebral ischemia group were significantly higher than those in normal group (t = 0.71-1.558, P> 0.05), HDL, HDL2 and HDL3 were lower than those in normal group (t = 0.34-0.92, P> 0.05 ), LDL was higher than the normal group (t = 2.72, P <0.05), ApoA1 and A / B were lower than the normal group (t = 4.99, P <0.05). HDL2 in subcortical arteriosclerotic encephalopathy group was lower than that in normal group (t = 2.16, P <0.05), while TC, TG, HDL, HDL3, LDL, ApoA1, ApoB100 and A / B were similar to those in chronic cerebral ischemia group. Hypertension frequency was significantly higher in the group with chronic cerebral ischemia than in the normal group (r = 0.0238, P <0.05), while smoking frequency was similar in both groups (r = 1.4806, P> 0.05). Logistic regression suggests that LDL and hypertension are the only risk factors for chronic white matter ischemia. Conclusions Higher LDL and lower HDL2, ApoA1, A / B levels in plasma of over 50 years old may be considered as potential risk factors for cerebrovascular disease, especially when accompanied by hypertension.