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目的:探讨不同年龄段和不同性别的椎基底动脉供血不足患者的经颅多普勒血管波动指数值差异与血脂间的关系。方法:收集2002-01/2004-03中南大学湘雅医院收治的椎基底动脉供血不足住院患者110例(33～50岁26例,男15例,女11例;51～87岁84例,男45例,女39例),同期健康体检者60人(33～50岁20人,男10人,女10人;51～87岁40人,男20人,女20人)。所有被试者抽血测血脂,并做经颅多普勒检查得出血管波动指数,两组均按年龄段比较不同性别患者的血脂和血管波动指数。结果:按意向处理分析,170例被试者均进入结果分析。①30～50岁年龄组血脂结果:两组女性间比较无差异(P>0.05),男性椎基底动脉供血不足患者三酰甘油和低密度脂蛋白胆固醇高于健康对照组犤(1.78±1.44),(1.03±0.38)mmol/L;(2.53±0.96),(2.20±0.70)mmol/L,P<0.05犦,高密度脂蛋白胆固醇低于健康对照组犤(1.20±0.33),(1.40±0.31)mmol/L,P<0.05犦。②30～50岁年龄组血管波动指数:男性椎基底动脉供血不足患者显著高于健康对照组(0.89±0.23,0.65±0.15,P<0.01),女性间比较无差异。③51～87岁年龄组血脂结果:男性和女性椎基底动脉供血不足患者三酰甘油均高于健康对照组犤(1.61±0.90),(1.26±0.84)mmol/L;(1.57±0.72),(1.25±0.72)mmol/L,P<0.05犦,其他各项两组间均无差异。④51～87岁年龄组血管波动指数无论男、女均无差异。结论:年轻椎基底动脉供血不足患者,其血管波动指数值、血脂在男女间有明显差别;而50岁以上,男女有无椎基底动脉供血不足症状其血管波动指数值在统计学上无显著差异,但血中三酰甘油明显升高。这提示不同年龄段、不同性别间椎基底动脉供血不足的发病机制可能不同。
OBJECTIVE: To investigate the relationship between transcranial Doppler (PV) index and blood lipids in patients with vertebrobasilar insufficiency at different ages and genders. Methods: Totally 110 inpatients with vertebrobasilar insufficiency admitted from Xiangya Hospital of Central South University from January 2002 to March 2004 were selected. Among them, 26 cases were 33 to 50 years old, including 15 males and 11 females; 84 45 cases and 39 females), and 60 healthy subjects (20 persons aged 33-50 years, 10 males and 10 females; 40 persons aged 51-87 years, 20 males and 20 females) during the same period. All the subjects took blood to measure the blood fat, and made the transcranial Doppler examination to get the index of blood vessel fluctuation. The blood lipid and the blood vessel fluctuation index of the two groups were compared by age group. Results: According to the intention-to-treat analysis, 170 subjects were involved in the result analysis. (1) Serum triglyceride and low density lipoprotein cholesterol were lower in male patients with vertebrobasilar artery insufficiency than those in healthy control group (1.78 ± 1.44), but no difference was found between the two groups (P> 0.05) (1.03 ± 0.38) mmol / L, (2.53 ± 0.96) and (2.20 ± 0.70) mmol / L respectively, P <0.05 犦 and high density lipoprotein cholesterol were significantly lower than those in healthy controls (1.20 ± 0.33 and 1.40 ± 0.31 ) mmol / L, P <0.05 犦. ②Vascular fluctuation index in 30 ~ 50 age group: The incidence of vertebrobasilar insufficiency in male was significantly higher than that in healthy control group (0.89 ± 0.23,0.65 ± 0.15, P <0.01). There was no difference between female patients. (3) Serum lipids in the age group of 51-87 years: The triglycerides in patients with vertebrobasilar insufficiency in both men and women were significantly higher than those in healthy controls (1.61 ± 0.90, 1.26 ± 0.84 mmol / L, 1.57 ± 0.72, 1.25 ± 0.72) mmol / L, P <0.05 犦. There was no difference between the other two groups. ④ In the 51-87 year-old group, there was no difference in the index of blood vessel fluctuation between men and women. CONCLUSIONS: In young patients with vertebrobasilar insufficiency, the index of blood vessel volatility and blood lipids are significantly different between men and women. However, there is no significant difference in the index of vascular fluctuation between men and women with or without vertebrobasilar insufficiency over 50 years of age , But blood triglyceride was significantly higher. This suggests that different age groups, different gender differences in the pathogenesis of vertebrobasilar insufficiency may be different.