Aull S, Lalouschek W, Schnider P, Sinzinger H, Uhl F, Zeiler K
Neurological Clinic, University of Vienna, Austria.
Am J Med. 1996 Sep;101(3):291-8. doi: 10.1016/S0002-9343(96)00199-4.
Only few data are available concerning variations of lipids and lipoproteins in the acute stage after ischemic cerebrovascular events. It was the aim of this study to investigate whether the lipid and lipoprotein levels obtained in the first few days after a transient ischemic attack (TIA) or a minor stroke (MS) actually reflect "correct' values or "changed' (ie, false low) values, as in patients after acute myocardial infarction.
Total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and triglyceride (TG) levels of 37 unselected patients with TIA or MS were determined within 12-48 hours (Group A) or within 49-168 hours (Group B) after the acute event. After a mean observation period of 15.3 months, all patients were re-examined; the results were compared with those of the baseline evaluation.
At the time of the baseline evaluation, TC and LDL-C levels of Group B patients were significantly lower than Group A levels. At the end of the observation period, however, Group A and Group B patients did not differ with regard to all four parameters. In comparison with the baseline examination, the values of Group A patients had not changed. In Group B patients, however, TC, HDL-C, LDL-C, and TG levels had significantly increased.
Our results strongly suggest that lipid and lipoprotein levels of patients with TIA or MS should be assessed within a maximum of 48 hours after the acute event. If the examination cannot be performed within that period, the determination of reliable values is possible only after several weeks or months.
关于缺血性脑血管事件急性期脂质和脂蛋白变化的数据很少。本研究旨在调查短暂性脑缺血发作(TIA)或轻度卒中(MS)后最初几天测得的脂质和脂蛋白水平是否真的反映“正确”值或“改变”(即假性降低)值,就像急性心肌梗死后的患者那样。
对37例未经选择的TIA或MS患者在急性事件发生后12 - 48小时内(A组)或49 - 168小时内(B组)测定总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)水平。平均观察期为15.3个月后,对所有患者进行复查;将结果与基线评估结果进行比较。
在基线评估时,B组患者的TC和LDL-C水平显著低于A组。然而,在观察期末,A组和B组患者在所有四个参数方面没有差异。与基线检查相比,A组患者的值没有变化。然而,B组患者的TC、HDL-C、LDL-C和TG水平显著升高。
我们的结果强烈表明,TIA或MS患者的脂质和脂蛋白水平应在急性事件发生后最多48小时内进行评估。如果在此期间无法进行检查,只有在数周或数月后才能确定可靠的值。