Tell G S, Crouse J R, Furberg C D
Center for Prevention Research and Biometry, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Stroke. 1988 Apr;19(4):423-30. doi: 10.1161/01.str.19.4.423.
Although blood lipids and lipoproteins are strongly related to coronary atherosclerosis, their association with cerebrovascular atherosclerosis is less clear. A review of more than 20 publications in which a relation was sought between plasma lipid and lipoprotein concentrations and cerebrovascular atherosclerosis leads to the general conclusion that such a relation exists and that it is stronger in older than in younger individuals. A relation was found between blood lipids and/or lipoproteins and the extent and/or severity of cerebrovascular atherosclerosis in all but three of 26 reviewed studies. However, the specific nature of the relation is obscure because the various studies cannot easily be compared with one another. Interstudy variations in lipoprotein fraction analyzed, methodology for the analysis of lipids and lipoproteins, arterial segment examined, population sampled, control selection in case-control studies, statistical analytic approach taken, and methodology for the assessment of arterial disease preclude pooled analyses. There is a clear need for further evaluation of this relation using standardized and up-to-date methodologies both for analyses of lipids and lipoproteins and for assessment of cerebrovascular disease in symptom-free volunteers as well as in symptomatic patients.
尽管血脂和脂蛋白与冠状动脉粥样硬化密切相关，但其与脑血管粥样硬化的关联尚不清楚。对20多篇探讨血浆脂质和脂蛋白浓度与脑血管粥样硬化之间关系的出版物进行综述后得出的总体结论是，这种关系是存在的，而且在老年人中比在年轻人中更为明显。在26项综述研究中，除了3项之外，其余所有研究均发现血脂和/或脂蛋白与脑血管粥样硬化的范围和/或严重程度之间存在关联。然而，这种关系的具体性质尚不清楚，因为各项研究之间难以相互比较。所分析的脂蛋白组分、脂质和脂蛋白的分析方法、检查的动脉节段、抽样人群、病例对照研究中的对照选择、采用的统计分析方法以及动脉疾病的评估方法等方面的研究间差异使得无法进行汇总分析。显然需要采用标准化的最新方法，对无症状志愿者以及有症状患者的脂质和脂蛋白进行分析，并对脑血管疾病进行评估，以进一步评估这种关系。
