目的通过观察心脑血管疾病患者血清脂蛋白(a)〔Lp(a)〕和红细胞变形指数的变化及二者的关系,为临床防治心脑血管疾病提供理论依据。方法将病人分为两组:脑梗死组41例,冠心病(心绞痛)组44例,选择39例健康体检者作为对照组。于清晨空腹抽血测血脂、Lp(a)、红细胞变形/聚集指数。比较各组与对照组间各指标水平的差异,并将各组Lp(a)异常率〔Lp(a)〕300mg/L与对照组作比较,以评价Lp(a)异常时发生心脑血管疾病的相对危险度;对Lp(a)与红细胞变形指数作相关分析。结果(1)Lp(a)在脑梗死组和冠心病组与对照组比较明显升高(P<0.01,P<0.05)。(2)Lp(a)异常率在脑梗死和冠心病组与对照组比较有明显增多(P<0.01,P<0.05),且当Lp(a)>300mg/L时,冠心病发病的危险性增加4.87倍,脑梗死发病的危险性增加7.61倍。(3)红细胞变形/聚集指数在各组中均与对照组有显著差异(P<0.01)。(4)Lp(a)在各组中均与红细胞变形指数呈负相关(P<0.01)。结论(1)Lp(a)浓度升高是心脑血管疾病的危险因素,高浓度的Lp(a)使心脑血管疾病发病的危险性明显增加。(2)高浓度的Lp(a)对心脑血管疾病的影响除通过降低血浆纤溶酶原活性而致动脉硬化和血栓形成外,还通过降低红细胞变形能力,导致微循环障碍,微血栓形成。 Objective To observe the changes of serum lipoprotein (a) 〔Lp (a)〕 and erythrocyte deformability index in patients with cardiovascular and cerebrovascular diseases and to provide a theoretical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases. Methods The patients were divided into two groups: 41 cases of cerebral infarction group, 44 cases of coronary heart disease (angina pectoris group) and 39 cases of healthy subjects as control group. Fasting blood in the morning to measure blood lipids, Lp (a), erythrocyte degeneration / aggregation index. The difference of each index between each group and the control group was compared, and the abnormal rate of Lp (a) 〔300mg / L) in each group was compared with the control group to evaluate the occurrence of cardiovascular and cerebrovascular The relative risk of disease; correlation analysis of Lp (a) and erythrocyte deformability index. Results (1) Lp (a) increased significantly in cerebral infarction group and coronary heart disease group compared with the control group (P <0.01, P <0.05). (2) The abnormal rate of Lp (a) in cerebral infarction and coronary heart disease group was significantly higher than that in control group (P <0.01, P <0.05), and the risk of coronary heart disease was higher when Lp (a)> 300mg / L Sex increased 4.87 times, the risk of cerebral infarction increased by 7.61 times. (3) The erythrocyte deformation / aggregation index in each group were significantly different from the control group (P <0.01). (4) Lp (a) was negatively correlated with erythrocyte deformability index in all groups (P <0.01). Conclusions (1) Lp (a) concentration is a risk factor of cardiovascular and cerebrovascular diseases. High concentration of Lp (a) significantly increases the risk of cardiovascular and cerebrovascular diseases. (2) The effect of high concentration of Lp (a) on cardiovascular and cerebrovascular diseases is caused by microcirculation disorder and microthrombus formation by reducing erythrocyte deformability in addition to arteriosclerosis and thrombosis by decreasing plasma plasminogen activity .