青壮年男性四肢瘫和截瘫患者血脂水平比较研究

摘要

目的:通过回顾性调查资料比较脊髓损伤所致四肢瘫和截瘫青壮年男性血脂水平,探讨在缺乏运动状态下不同运动能力对青壮年男性血脂代谢的影响和差异形成机制,为血脂异常防治提供指导.方法:对中国康复研究中心2004-2010年因脊髓损伤致瘫痪进行康复治疗的青壮年男性患者进行入院状态回顾性调查,入选要求:①诊断明确(脊髓损伤致瘫痪)；②资料完整；③18周岁≤年龄≤60岁；④非卒中患者.共1812例患者入选,对血脂指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]进行比较分析.结果:截瘫组平均TG、TC、HDL水平显著高于四肢瘫痪组(分别为TG 1.79±1.22mmol/L比1.56±0.87mmol/L;TC4.42±0.92mmol/L比4.25±0.93mmol/L;HDL 1.14±0.35mmol/L比1.06±0.35mmol/L,P＜0.01),高TG发生率显著高于四肢瘫痪组(分别为36％比28％,P＜0.01),而低HDL血症发生率显著低于四肢瘫痪组(47％比57％,P＜0.01),两组患者LDL水平及异常发生率均无显著差异,TC异常发生率两组无显著差异.结论:男性截瘫患者与四肢瘫患者TG、TC、HDL水平存在显著差异,提示上肢自主活动功能对TG、TC和HDL代谢有显著影响,既有HDL水平提高而获益的一面,也同时有TG、TC异常升高的不利面,其机制可能与运动量和饮食摄入差异有关；LDL的代谢并未受运动量和饮食因素的影响.%Objective: To study the mechanism of lipids disorder in Chinese spinal cord injury (SCI)men by comparison of lipids profile between tetraplegics and paraplegics based on retrospective data.Method: A total of 1812 male SCI patients who admitted in China Rehabilitation Research Center (CRRC) for re-habilitation therapy from Jan 2004-Dec 2010 were retrospectively investigated, inclusion criteria: ①definite SCI history; ②complete data; ③18-60 years old; ④non-stroke. Lipid profiles include triglyceride (TG), total choles-terol (TC), low density lipid (LDL), and high density lipid (HDL). SPSS 13.0 was used for analyses. Result: Men with chronic paraplegia showed higher mean TG、TC and HDL levels than those with chronic tetra-plegia (TG 1.79 ± 1.22 mmol/L vs 1.56 ± 0.87mmol/L;TC 4.42 ± 0.92 mmol/L vs 4.25 ± 0.93mmol/L;HDL 1.14 ± 0.35mmol/L vs 1.06 ± 0.35mmol/L respectively, P<0.01). There was no significant difference in LDL level and prevalence of abnormal TC level between paraplegics and tetraplegics. Men with chronic paraplegia showed higher prevalence of abnormal high TG level(36% vs 28%,/J<0.0l) and lower prevalence of abnormal low HDL level (47% vs 57%, P< 0.01)than those with chronic tetraplegia.Conclusion: Arm exercises have significant effect on metabolism of TG^TC and HDL in male SCI patients, by which patients with chronic paraplegia could benefit from elevated HDL, meanwhile suffer from elevated TG and TC levels. Difference of LDL was not significant between two groups. The differences of lipids maybe result from difference of exercise and food uptake.