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目的 探讨中青年脑卒中的危险因素及载脂蛋白E(apoE)与中青年动脉粥样硬化性脑梗死的关系。方法 以中青年脑卒中病人 79例为研究对象 ,采用成组对照研究 ,选取其大脑中动脉粥样硬化性脑梗死 (ACI) 4 3例和健康对照组之间应用聚合酶链反应 限制性长度多态性技术 (PCR RFLP)进行apoE基因型分析 ,中青年脑卒中病人和对照组进行危险因素研究。结果 中青年ACI组apoE基因型ε3/4的频率为30 .2 % ,明显高于对照组 (P <0 .0 5 )。中青年ACI患者中ε3/3和ε3/4亚组血清Lp(a)均明显高于对照组 (P<0 .0 5 ) ,而高密度脂蛋白低于对照组 (P <0 .0 5 )。中青年脑卒中病人危险因素分析发现Lp(a)、收缩压、舒张压、腰臀比明显高于对照组 (P <0 .0 1) ,而高密度脂蛋白低于对照组 (P <0 .0 1)。病人组中有高血压、脑血管病家族史、吸烟史人数明显多于对照组。结论 apoE基因型ε3/4与中青年ACI的发生相关 ,等位基因可能是中青年ACI的一种遗传易感因子。高密度脂蛋白下降是中青年脑卒中病人最重要的危险因素 ,Lp(a)、高血压、腰臀比、吸烟和有高血压、脑血管病家族史也是重要的危险因素。
Objective To investigate the risk factors of middle-aged and young stroke and the relationship between apolipoprotein E (apoE) and middle-aged and young patients with atherosclerotic cerebral infarction. Methods A total of 79 middle-aged and young stroke patients were enrolled in this study. A group control study was conducted. 43 patients with cerebral atherosclerosis cerebral infarction (ACI) and 40 healthy controls were enrolled in this study. The polymerase chain reaction restriction length Polymorphism (PCR RFLP) was used to analyze the apoE genotype, and risk factors of middle-aged and young stroke patients and control group were studied. Results The frequency of ε3 / 4 of apoE genotype in young and middle-aged ACI group was 30.2%, which was significantly higher than that in control group (P <0.05). The levels of serum Lp (a) in the ε3 / 3 and ε3 / 4 subgroups of middle-aged and young ACI patients were significantly higher than those of the control group (P0.05), while the levels of high density lipoprotein were lower than those of the control group (P0.05) ). Analysis of risk factors of stroke in young and middle-aged patients showed that Lp (a), systolic blood pressure, diastolic blood pressure and waist-hip ratio were significantly higher than those of the control group (P <0.01), but high density lipoprotein was lower than that of the control group .0 1). Patients in the group of hypertension, family history of cerebrovascular disease, smoking history significantly more than the control group. Conclusion The apoE genotype ε3 / 4 is associated with the occurrence of middle-aged and young ACI. The allele may be a genetic predisposition to middle-aged and young ACI. High-density lipoprotein decline is the most important risk factor for stroke in middle-aged and young people. Lp (a), hypertension, waist-to-hip ratio, smoking and hypertension, family history of cerebrovascular disease are also important risk factors.