Groupe de recherche sur la thrombose, EA 3065, Université Saint-Etienne, Saint-Etienne, France.
Neonatology. 2010;98(3):225-8. doi: 10.1159/000281015. Epub 2010 Apr 13.
Elevated lipoprotein (Lp) (a) is the most common genetically determined risk factor found in babies with perinatal ischemic stroke. The influence of maternal Lp(a) has not been studied extensively to date.
To investigate the role of Lp(a) in our population of neonates with stroke.
In a prospective uncontrolled cohort of term-born children with neonatal arterial ischemic stroke, Lp(a) levels were investigated in 69 mothers and 69 children. Paternal Lp(a) was not explored.
An increased Lp(a) level was found in 26 mothers [38%; 95% confidence interval (CI) 28-50%] and in 15 children (22%; 95% CI 13-33%). Both rates were higher than the reference range reported in the general Caucasian population (10% in adults and 5% in children). Additionally, there was a correlation between maternal and infantile Lp(a) levels (p < 0.0001) and between elevated maternal Lp(a) level and lower birth weight (p = 0.027).
Elevated maternal Lp(a) is apparently a risk factor for neonatal arterial ischemic stroke. We speculate that the pathological mechanism of this relation may be mediated through a dysfunction of the placental vascularization.
脂蛋白 (a)（Lp(a)）升高是围产期缺血性脑卒中婴儿中最常见的遗传决定的风险因素。迄今为止，尚未广泛研究母体 Lp(a) 的影响。
研究 Lp(a) 在我们的脑卒中新生儿人群中的作用。
在一项对足月出生的新生儿动脉缺血性脑卒中的前瞻性非对照队列研究中，我们研究了 69 位母亲和 69 位儿童的 Lp(a) 水平。未探讨父系 Lp(a)。
26 位母亲（38%；95%置信区间 [CI] 28-50%）和 15 位儿童（22%；95% CI 13-33%）存在 Lp(a) 水平升高。这两个比率均高于一般白种人群中报告的参考范围（成人 10%，儿童 5%）。此外，母亲和婴儿的 Lp(a) 水平之间存在相关性（p<0.0001），以及母体 Lp(a) 水平升高与出生体重较低之间存在相关性（p=0.027）。
母体 Lp(a) 升高显然是新生儿动脉缺血性脑卒中的一个危险因素。我们推测这种关系的病理机制可能通过胎盘血管功能障碍来介导。
