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老年轻型急性缺血性卒中患者非HDL-C/HDL-C比值与1年卒中复发的关系研究OACSTPCD

Research on the Relationship between Non-HDL-C/HDL-C Ratio and One-Year Stroke Re-currence in Elderly Patients with Mild Acute Ischemic Stroke

中文摘要英文摘要

目的:探讨非高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和HDL-C的比值与老年轻型急性缺血性卒中(acute ischemic stroke,AIS)患者1年卒中复发风险之间的关系.方法:通过西安卒中登记研究数据库,连续收集患者入院时的总胆固醇、HDL-C及相关临床信息和确诊起3、6、12个月随访复发性脑卒中事件.非HDL-C通过从总胆固醇中减去HDL-C来计算.非HDL-C/HDL-C比值分别按照连续变量和四分位分组(Q1~Q4)处理.采用多因素Cox回归分析非HDL-C/HDL-C比值与老年轻型AIS患者1年卒中复发风险之间的关系.并采用Kaplan-Meier法进行不同非HDL-C/HDL-C比值的1年卒中复发分析.结果:研究共纳入老年轻型AIS患者826例.校正相关混杂因素后多因素Cox回归分析发现,非HDL-C/HDL-C比值每升高1个单位,1年卒中复发的风险升高54%(HR=1.54,95%CI 1.15~2.07,P=0.004).与Q1组相比,Q4组的1年卒中复发风险升高2.27倍(HR=3.27,95%CI 1.21~8.81,P=0.019),其他组(Q2和Q3组)中1年卒中复发风险与Q1组差异无统计学意义.趋势检验显示,Q1~Q4组的1年复发风险增加有显著性统计学意义(趋势检验P=0.004).曲线拟合分析显示随着非HDL-C/HDL-C比值的升高,1年卒中复发的风险逐步升高.四分组的K-M生存分析发现,与其他组相比,Q4组(≥3.58)的1年卒中复发率明显升高.结论:非HDL-C/HDL-C比值升高是老年轻型AIS患者1年卒中复发的独立危险因素,非HDL-C/HDL-C比值≥3.58可显著增加老年轻型AIS患者1年卒中复发的风险.

Objective:To investigate the relationship between the ratio of non-high-density lipoprotein choles-terol(non-HDL-C)to high-density lipoprotein cholesterol(HDL-C)and the risk of one-year stroke recurrence in elderly patients with mild acute ischemic stroke(AIS).Methods:Through the Xi'an Stroke Registry Research database,we continuously collected patients'total cholesterol,HDL-C,and related clinical information at the time of admission,as well as follow-up data on recurrent stroke events at 3,6,and 12 months after diagnosis.Non-HDL-C was calculated by subtracting HDL-C from total cholesterol.The non-HDL-C/HDL-C ratio was an-alyzed both as a continuous variable and as quartile groups(Q1~Q4).Multivariate Cox regression analysis was used to explore the relationship between the non-HDL-C/HDL-C ratio and the risk of one-year stroke recurrence in elderly patients with mild AIS.The Kaplan-Meier method was employed to analyze one-year stroke recur-rence for different non-HDL-C/HDL-C ratios.Results:A total of 826 elderly patients with mild AIS were in-cluded in the study.After adjusting for relevant confounding factors,multivariate Cox regression analysis re-vealed that for each unit increase in the non-HDL-C/HDL-C ratio,the risk of one-year stroke recurrence in-creased by 54%(HR=1.54,95%CI 1.15~2.07,P=0.004).Compared to the Q1 group,the risk of one-year stroke recurrence was 2.27 times higher in the Q4 group(HR=3.27,95%CI 1.21~8.81,P=0.019),while there was no statistically significant difference in the risk of one-year stroke recurrence between other groups(Q2 and Q3)and Q1.The trend test showed a significant statistical increase in one-year recurrence risk from Q1 to Q4 groups(trend test P=0.004).Curve fitting analysis indicated that as the non-HDL-C/HDL-C ratio increased,the risk of one-year stroke recurrence gradually rose.K-M survival analysis of the quartiles found that compared to other groups,the one-year stroke recurrence rate was significantly higher in the Q4 group(≥3.58).Conclusion:An elevated non-HDL-C/HDL-C ratio is probably an independent risk factor for one-year stroke recurrence in elder-ly patient with mild AIS,and a ratio ≥ 3.58 significantly increases the risk of one-year stroke recurrence in these patients.

王欢;刘仲仲;蔺雪梅;张娜;逯青丽;刘佩;常乔乔;刘燕;吴松笛

西北大学附属第一医院/西安市第一医院神经内科 西安 710002||西安市神经免疫疾病创新转化重点实验室 西安 710002西北大学附属第一医院/西安市第一医院神经内科 西安 710002||西安市神经免疫疾病创新转化重点实验室 西安 710002||西安交通大学医学部公共卫生学院流行病与卫生统计学系 西安 710061

临床医学

急性缺血性卒中;老年;非传统;血脂;复发

acute ischemic stroke;elderly;non-traditional;serum lipid;recurrence

《神经损伤与功能重建》 2024 (004)

211-216 / 6

陕西省科技计划项目(超重和肥胖脑卒中患者血清残余胆固醇水平对入院严重程度及其预后的影响,No.2023-YBSF-041);西安市科技计划项目(残余胆固醇水平与超重和肥胖卒中患者入院严重程度及其预后的相关研究,No.22YXYJ0061;急性视交叉后部视觉通路脑卒中患者视网膜特征评估,No.22YXYJ0074);西安市卫生健康委员会科研项目(Non-HDL-c/HDL-c比值对非致残性缺血性卒中患者预后的预测价值研究,No.2021yb33)

10.16780/j.cnki.sjssgncj.20221114

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