ASSOCIATIONS OF SERUM TOTAL CHOLESTEROL, DIFFERENT TYPES OF STROKE, AND STENOSIS DISTRIBUTION OF CEREBRAL-ARTERIES THE AKITA PATHOLOGY STUDY
ASSOCIATIONS OF SERUM TOTAL CHOLESTEROL, DIFFERENT TYPES OF STROKE, AND STENOSIS DISTRIBUTION OF CEREBRAL-ARTERIES THE AKITA PATHOLOGY STUDY
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DOI：
10.1161/01.str.24.7.954
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发表时间：
1993-07-01
期刊：
影响因子：
8.3
通讯作者：
ITO, M
中科院分区：
文献类型：
--
作者：
KONISHI, M;ISO, H;ITO, M
背景和目的：血清总胆固醇水平与脑卒中的关系存在争议。秋田病理学研究提供了血清总胆固醇、不同类型中风和脑动脉狭窄分布之间的相关性数据。方法：这些数据是基于1966年至1984年日本东北部一家当地医院收治的750例年龄在30岁及以上的尸检男性。总体尸检率为88%。脑动脉狭窄程度是由一名病理学家使用Baker的基底脑动脉方法盲目确定的（动脉粥样硬化评分）和使用显微镜检查单个基底节载玻片的脑内穿通动脉（小动脉硬化评分）。脑出血患者血清总胆固醇浓度的年龄校正平均值为164 mg/dL，穿通动脉区域梗死患者为177 mg/dL，皮质动脉区域梗死的剂量为200 mg/dL。脑出血导致的死亡的平均血清胆固醇低于心肌梗死和其他心血管疾病导致的死亡。脑出血的基底动脉平均动脉粥样硬化评分较低，穿透动脉梗死居中，皮质动脉梗死较高。在脑出血的病例中，基底动脉和穿通动脉的狭窄最小或不存在。皮质动脉梗死仅基底动脉狭窄，而穿通动脉梗死基底动脉和穿通动脉均狭窄。血清胆固醇与基底动脉和穿通动脉狭窄呈正相关。在脑出血的情况下，血清总胆固醇水平甚至更低的男性没有显着狭窄的基底动脉或穿通动脉比男性狭窄的任何类型的artery.Conclusions：血清胆固醇与发病机制之间的关联中风类型各不相同。血清胆固醇水平升高与皮质动脉梗死相关，而血清胆固醇水平降低与脑出血相关。（中风1993;24：954-964）
Background and Purpose: The relation between serum total cholesterol levels and stroke is controversial. The Akita Pathology Study provides data on the association of serum total cholesterol, different types of stroke, and distribution of stenosis in cerebral arteries.Methods: The data are based on 750 autopsied men aged 30 years and older who were admitted to a local hospital in northeast Japan between 1966 and 1984. The overall autopsy rate was 88%. The grade of stenosis in the cerebral arteries was determined blindly by one pathologist using Baker's method for basal cerebral arteries (atherosclerosis scores) and using microscopic examination of a single basal ganglion slide for the intracerebral penetrating arteries (arteriolosclerosis scores).Results: The age-adjusted mean value of serum total cholesterol concentration was 164 mg/dL for cerebral hemorrhage, 177 mg/dL for infarction in penetrating artery regions, and 200 mg/dL for infarction in cortical artery regions. Mean serum cholesterol was lower in deaths caused by cerebral hemorrhage than in those caused by myocardial infarction and other cardiovascular disease. Mean atherosclerosis score of basal cerebral arteries was low for cerebral hemorrhage, intermediate for penetrating artery infarction, and high for cortical artery infarction. Stenosis of both basal and penetrating arteries was minimum or absent in cases of cerebral hemorrhage. Only the basal arteries were stenotic in cases of cortical artery infarction, whereas both basal and penetrating arteries were stenosed in cases of penetrating artery infarction. There were positive associations of serum cholesterol with stenosis of basal and penetrating arteries. Among cases of cerebral hemorrhage, serum total cholesterol levels were even lower in men with no significant stenosis in either basal or penetrating arteries than in men with stenosis in either type of artery.Conclusions: The association of serum cholesterol with pathogenesis varies among stroke types. Elevated serum cholesterol levels were associated with the presence of cortical artery infarction, while low serum cholesterol levels were associated with cerebral hemorrhage. (Stroke 1993;24:954-964)