低密度脂蛋白对普通肝素治疗急性脑梗死风险—效益评价的影响  

Effect of LDL-C on risk-benefit appraises about average heparin treated impatient brain infarction

作　　者：王志勇[1] 王利春[1] 高印生[1] 戈杰英[1] 闫瑞萍[1] 陈超[1] 

机构地区：[1]河北医科大学沧州中西医结合临床医学院,060001

出　　处：《山西医药杂志（上半月）》2011年第2期121-123,共3页Shanxi Medical Journal

基　　金：河北省科技厅基金(09276101D-18)

摘　　要：目的探讨低密度脂蛋白(LDL-C)对普通肝素治疗急性脑梗死风险-效益评价的影响。方法回顾性分析2006—2009年间住院的急性脑梗死病例,严格按照统一的筛选标准,从中选出年龄、性别、入院神经功能缺损评分、既往史、梗死类型、治疗方案相匹配的患者286例,根据肝素治疗7 d后临床转归情况将患者分成3组,A组:有效组;B组:无变化组;C组:恶化组。评价不同疗效组治疗前LDL-C之间的比较;探索LDL-C不同分段与肝素治疗后的改善率的关系;评价LDL-C值大小对肝素治疗有效性的预测价值,寻找LDL-C的判定界点;评价LDL-C值大小对肝素治疗安全性的预测价值,寻找LDL-C的判定界点。结果 3组患者治疗前LDL-C值大小之间差异有统计学意义,F=48.39,P<0.05。A组与B组(P<0.05)、A组与C组(P<0.05)之间差异有统计学意义(P<0.01),B组与C组(P=0.042)之间差异有统计学意义(P<0.05)。依据286例患者的LDL-C数据,按累计百分比分为10段,对LDL-C不同分段对应的肝素治疗后的改善率,进行线性趋势性检验,P<0.05。采用ROC分析不同分段界点对患者接受抗凝治疗有效性预测情况,其中以LDL=C为2.64mmol/L作为界点显示较好的预测效果,其敏感度为0.86,特异度为0.84。采用ROC分析不同分段界点对患者接受抗凝治疗安全性预测情况,其中以5.00mmol/L作为1界点显示较好的预测效果,其敏感度为0.96,特异度为0.50。结论利用LDL-C值的大小可以较好判定普通肝素治疗急性脑梗死的风险与效益。Objective To study effect of LDL-C on risk--benefit appraises about average heparin treating the impatient brain infarction. Methods To retrospectively analyze the impatient brain infarction case being in hospital during the 2006--2009 years according to unified screening standard strictly. The 286 examples according to age , sex , the nerve function defect grades, past medical history, infarct pattern and therapeutic scheme were appraised. After treated by average heparin, the patients were divided into three set according to clinical prognosis. A group： Effective group; B group： Nothing change group; C group： Worsen set. To estimate the comparison between LDL-C from the different curative effect forms before curing; To explore relation unlike paragraph division of LDL-C and the heparin cures improvement rate; To estimate that LDL-C value size treats the heparin the validity forecast value; to seek LDL-C the decision boundary; to estimate that LDL-C value size treats the heparin the security forecast value, to seek the LDL-C decision boundary. Results The LDL-C value size of three groups have a difference curing front, F = 48.3, P G 0.05 . Compared A with B , compared A with C, difference has statistics significance（ P G0.01 ）, compared B with C , difference has statistics significance（ P G0.05）. According to accumulated percentage,LDL-C （retool/L） of 286 patients data had been sub lcycled 10 paragraphs, and the linear trend test was carried on to improvement rate of unlike paragraph（ P G0.05）. Adopting ROC to analyze forecasting condition to the piecewise different boundary anti-freezing to cure validity, LDL-C as 2.64 mmol/L among in the boundary burns has good forecast, susceptibility is 0.86 , distinctive degree is 0.84. Adopting ROC to analyze forecasting condition to the piecewise different boundary anti-freezing to cure security, LDL-C as 5.00 mmol/ L among in the boundary burns has good forecast, susceptibility is 0.96, distinctive degree is 0.50. Conclusion LDL-C is able to judge r

关 键 词：肝素 脂蛋白类 LDL 脑梗塞 急性 风险-效益 

分 类 号：R743.3[医药卫生—神经病学与精神病学]