目的：探讨急性脑梗死伴脑内微出血患者血脂水平、β-淀粉样蛋白(β-AP)水平及其与脑内微出血的关系。方法选取2011年1月~2013年12月广东省河源市龙川县人民医院脑梗死患者98例，将其分为脑内微出血组(46例)和非脑内微出血组(52例)，另选择健康人50例为对照组。46例脑内微出血患者中，轻度20例，中度16例，重度10例。检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)、血清β-AP水平，并对血脂、血清β-AP水平与年龄、脑内微出血、脑内微出血严重程度、体重指数进行相关性分析。结果脑内微出血组血清TC、TG、LDL-C、β-AP水平均高于非脑内微出血组和对照组，差异有高度统计学意义(P<0.01)，非脑内微出血组血清TC、TG、LDL-C、β-AP水平高于对照组，差异有高度统计学意义(P<0.01)；但脑内微出血组HDL-C水平明显低于非脑内微出血组和对照组，差异有高度统计学意义(P<0.01)，非脑内微出血组HDL-C水平低于对照组(P<0.01)。随着脑内微出血严重程度加重，血清TC、TG、LDL-C、β-AP水平均明显上升，差异有高度统计学意义(P<0.01)；随着脑内微出血严重程度加重，血清HDL-C水平明显下降，差异有高度统计学意义(P<0.01)；血清TC、TG、LDL-C、β-AP水平与脑内微出血、脑内微出血严重程度均呈正相关(r=0.25~0.45，P<0.05)；HDL-C水平与脑内微出血、脑内微出血严重程度呈负相关(r=-0.36、-0.32，P<0.05)。结论血脂、β-AP在脑内微出血患者血清中存在异常表达，与脑内微出血发病及病情进展密切相关。%Objective To study the blood lipid andβ-amyloid beta protein and levels the correlation between them and cerebral microbleeds in patients with acute cerebral infarction. Methods From January 2011 to December 2013, in the People's Hospital of Longchuan County in Heyuan City, 98 patients with cerebral infarction were selected and divided into cerebral microbleeds group (46 cases) and non-cerebral microbleeds group (52 cases), 50 of healthy people were selected as control group. In 46 patients with cerebral infarction, 20 cases were mild, 16 cases were moderate, 10 cases were severe. Total cholesterol (TC), glycerin three fat (TG), low density lipoprotein cholesterol (LDL-C) and high densi-ty lipoprotein cholesterol (HDL-C), serum β-AP level were tested. The relationships between serum lipids, serum β-AP and age, cerebral microbleeds severity in patients with cerebral microbleeds, were studied, BMI correlation analysis were made. Results In cerebral microbleeds group, serum TC, TG, LDL-C,β-AP level were higher than those in non-cerebral microbleeds group and control group, the differences were statistically significant (P<0.01), and these in non-cerebral microbleeds were higher than those in the control group, the differences were statistically significant (P <0.01);but the HDL-C level in cerebral microbleeds group was significantly lower than that in non-cerebral microbleeds group and the control group, the difference was statistically significant (P< 0.01), HDL-C level of non-cerebral mi-crobleeds group was lower than that in the control group (P< 0.01). With the severity of cerebral microb-leeds exacerbation, serum TC, TG, LDL-C, β-AP levels were increased, the differences between two groups were sta-tistically significant (P< 0.01); with the severity of cerebral microbleeds exacerbation, the serum level of HDL-C was significantly decreased, the differences between two groups were statistically significant (P< 0.01). There was positive correlation between serum TC, TG, LDL-C, β-AP levels and cerebral microbleeds, the severity of cerebral microbleeds (r=0.25-0.45, P<0.05);there was negative correlation between HDL-C and cerebral microbleeds, the severity of cere-bral microbleeds (r=-0.36,-0.32, P<0.05). Conclusion Blood lipid, β-AP in serum of patients with cerebral microb-leeds present abnormal expression, and they are closely related to the progress and the onset of cerebral microbleeds.
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