The dynamic changes of the serum levels of total cholesterol(TC), triglyceride(TG), high density lipoprotein-cholesterol(HDL-c) and subfraction(HDL2-c), apolipoprotein(Apo) A-I, ApoB, lipoprotein(a)[Lp(a)] and fibrinogen(Fg) were measured in forty-one patients with acute[including 31 cerebral hemorrhagic patients(ICH), and 10 cerebral infraction patients(CI)]. The results showed that the serum levels of HDL-c and subfractions, ApoA-I and TC gradually decreased in ICH during acute phase, and reduced to the lowest level on the fourteenth day, while the levels of TG and ApoB had no obvious change, the serum levels of Fg and Lp(a) increased to the highest level on the seventh day. The serum levels of Lp(a), ApoB and TG had no obvious change in CI during acute phase, and the serum levels of TC, HDL-c and subfraction, ApoA-I decreased, while the level of Fg increased in CI, but there was no statistical significance. It is suggested that Lp (a) is a positive acute reactive lipoprotein in ICH, and HDL and ApoA-I are negative acute reactive substances in ICH and CI.