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背景:一些流行病学和动物试验显示高脂蛋白(a)与动脉硬化和脑梗死相关,但是高脂蛋白(a)是否为年轻人脑梗死潜在的危险因素一直存在争议。目的:调查脂蛋白(a)与年轻人脑梗死的关系。设计:非随机对照的实验研究。地点和对象:1995-01/2001-07湘雅医院神经内科住院的16～45岁的脑梗死患者。方法:对年龄低于45岁的脑梗死患者及性别年龄匹配的对照组进行血清脂蛋白(a)和其他血脂成分的测定,询问其他可能的危险因素。主要观察指标:血清脂蛋白(a)和其他血脂成分及其他可能的危险因素。结果:脑卒中患者和对照组血清脂蛋白(a)水平差异未见显著性,脑卒中患者的三酰甘油显著高于对照组(P<0.001),高脂蛋白(a)的OR值为1.547(95%CI0.601～3.982),而高三酰甘油血症和高血压的OR值分别为2.597(95%CI1.149～5.381)和4.639(95%CI1.949～11.040)。结论:脂蛋白(a)可能不是年轻人脑梗死的危险因素,高三酰甘油血症和高血压则是重要的危险因素。
BACKGROUND: Some epidemiological and animal studies have shown that hyperlipoprotein (a) is associated with arteriosclerosis and cerebral infarction. However, whether or not hyperlipoprotein (a) is a potential risk factor for cerebral infarction in young people remains controversial. Objective: To investigate the relationship between lipoprotein (a) and cerebral infarction in young adults. Design: Non-randomized controlled experimental study. Location and Subjects: Patients aged 16-45 years with cerebral infarction hospitalized in Department of Neurology, Xiangya Hospital from January 1995 to July 2001. METHODS: Serum lipoprotein (a) and other lipid components were measured in patients with cerebral infarction below 45 years of age and in gender-age matched controls and other possible risk factors. MAIN OUTCOME MEASURES: Serum lipoprotein (a) and other lipid components and other possible risk factors. Results: There was no significant difference in serum lipoprotein (a) level between stroke patients and control group. The triglyceride level in stroke patients was significantly higher than that in control group (P <0.001). The odds ratio of hyperlipoprotein (a) was 1.547 (95% CI0.601 ~ 3.982). The OR of hypertriglyceridemia and hypertension were 2.597 (95% CI, 1.49-5.381) and 4.639 (95% CI, 1.949-11.040), respectively. CONCLUSION: Lipoprotein (a) may not be a risk factor for cerebral infarction in young adults, and hypertriglyceridemia and hypertension are important risk factors.