急性缺血性脑卒中患者出血转化与血脂水平的关系  

Study on the relationship of hemorrhagic transformation after acute ischemic stroke and the level of fasting blood lipid

作　　者：汤媛媛[1] 秦超[1] 梁志坚[1] 赵伟佳[1] 李茂[2] 龙莉玲[2] 

机构地区：[1]广西医科大学第一附属医院神经内科,南宁530021 [2]广西医科大学第一附属医院放射科

出　　处：《中国神经精神疾病杂志》2011年第12期740-743,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨血脂水平对急性缺血性脑卒中出血转化(hemorrhagic transformation,HT)影响及其规律。方法连续收录广西医科大学第一附院神经内科2009年1月至2010年12月期间确诊急性缺血性脑卒中病例。收录内容包括性别、起病年龄、既往病史、神经功能缺失严重程度、血压、血糖、血脂水平、缺血性脑卒中病因、梗死面积及部位。以上因素与HT关系采用非条件Logistic回归分析。结果共纳入665例急性缺血性脑卒中病例,HT 68例。大面积梗死、皮层梗死、空腹血糖、空腹血清总胆固醇水平、既往高血压史与HT有关;空腹血清总胆固醇水平每降低1 mmol/L,HT发生率增高35.6%(OR:0.644;95%CI:0.456～0.908;P=0.012)。结论空腹血清总胆固醇水平与HT有关;随着空腹血清总胆固醇水平降低,HT发生率呈增高趋势。Objiective To discuss the relationship of hemorrhagic transformation（HT） after acute ischemic stroke and the level of fasting blood lipid.Methods Consecutive patients admitted to the First Affiliated Hospital to Guangxi Medical University with objectively diagnosed acute ischemic stroke between 1 January 2009 and 31 December 2010 were included.At admission,baseline demographic and clinical information was collected including gender,age of onset,past medical history,systolic blood pressure and diastolic blood pressure levels,fasting blood glucose level,levels of fasting total cholesterol（TC）,triglycerides（TG）,low-density lipoprotein cholesterol（LDL-C） and high-density lipoprotein cholesterol（HDL-C）,National Institute of Health Stroke Scale（NIHSS） score,etiology,size and location of stroke.Logistic regression analysis was used to examine the association between HT and above factors.Results A total of 665 acute ischemic stroke patients were consecutively enrolled in this study.HT after ischemic stroke was found in 68 patients（10.2%） on follow-up brain CT or MR.Low level of TC was related to an increased HT after ischemic stroke.Every 1 mmol/L drop of TC level caused 35.6% increase in the risk of HT（OR,0.644 per 1-mmol/L increase;95%CI,0.456-0.908;P = 0.012）.Conclusions Low level of TC is associated with greater risk hemorrhagic transformation after acute ischemic stroke.

关 键 词：急性缺血性脑卒中继发出血转化 血清总胆固醇 

分 类 号：R743.3[医药卫生—神经病学与精神病学]