摘要目的 探讨青中年体检人群血脂水平与脑血流动力学指标(cerebrovascular hemodynamic indexes,CVHI)的关系,为脑卒中的早期预警提供参考.方法 选取2015年6月—2016年6月于贵州医科大学附属医院健康管理中心行脑血管功能检查青中年共6 252人.将其分为血脂异常组和血脂正常组,比较两组CVHI各项指标及积分的差异,分析CVHI积分的影响因素,并进行多因素Logistic回归分析.结果 青中年血脂异常组左右两侧的平均血流速度、最大血流速度、最小血流速和总积分显著低于血脂正常组(P<0.001),而脉搏波波速、特异性阻抗、外周阻力、动态阻力、临界压力和压差则高于血脂正常组(P<0.001).多因素Logistic回归分析结果显示,三酰甘油水平升高、超重、肥胖、收缩压升高、舒张压升高及年龄增长为青中年人群CVHI积分值降低的危险因素, OR(95%CI)分别为 1.455(1.195~1.771)、2.271(1.782~2.895)、5.967(4.557~7.815)、4.251(3.349~5.396)、2.560(1.993~3.287)、1.448(1.189~1.763).结论 血脂异常可导致青中年人群的脑血管功能异常;三酰甘油水平升高为青中年人群脑血管功能受损的独立危险因素.

abstractsObjective To explore the relationship between blood lipid levels and cerebrovascular hemodynamic indices (CVHI) in a young and middle?aged population, and to identify reference values for early warning of stroke. Method Between June 2015 and June 2016, a total of 6 252 young and middle?aged patients were assessed for cerebrovascular function in The Health Management Center of Affiliated Hospital of Guizhou Medical University. Patients were divided into abnormal and normal blood lipid groups. Differences in CVHI indicators and scores between the groups were determined, and factors influencing CVHI indices were compared using multivariate logistic regression analysis. Results Mean (Vmean), maximum (Vmax), and minimum blood flow velocity (Vmin) and cumulative scores for CVHI indices in the abnormal blood lipid group were significantly lower than in the normal blood lipid group (P<0.001). However, pulse wave velocity, characteristic impedance, peripheral vascular resistance, dynamic resistance, critical pressure, and differences between diastolic blood pressure and critical pressure were greater than those in the normal blood lipid group (P<0.001). Multivariate logistic regression analysis indicated that a high triglyceride level, overweight or obesity, high systolic blood pressure, high diastolic blood pressure, and age were risk factors for low CVHI scores, with odds ratios (95% confidence intervals) of 1.455 (1.195- 1.771), 2.271 (1.782-2.895), 5.967 (4.557-7.815), 4.251 (3.349-5.396), 2.560 (1.993-3.287), and 1.448 (1.189-1.763). Conclusion Abnormal blood lipid levels can lead to abnormal cerebrovascular function in young and middle?aged population; elevated triglyceride level was an independent risk factor for impaired cerebrovascular function.