低高密度脂蛋白胆固醇血症对缺血性脑卒中患者一年预后的影响  

Effect of low HDL-C on one-year outcome in patients with acute ischemic stroke

作　　者：钱怡宁 王拥军[2] 刘改芬[2] 潘岳松[2] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,100029 [2]首都医科大学附属北京天坛医院神经内科

出　　处：《中华老年心脑血管病杂志》2014年第7期676-681,共6页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家科技支撑计划(2006BAI01A11)

摘　　要：目的 分析低HDL-C与急性缺血性脑卒中患者1年预后的关系.方法 以前瞻性、多中心的中国国家卒中登记研究数据库中符合标准的住院患者8876例为研究对象,男性5555例,女性3321例.将HDL-C＜0.9 mmol/L的1440例患者作为低HDL-C,HDL-C≥0.9 mmol/L的7436例患者作为正常HDL-C.采用多变量logistic回归模型分析低水平HDL-C对缺血性脑卒中患者1年预后的影响.结果 8867例患者中低HDL-C发生率16.2％.低HDL-C与正常HDL-C患者基线血压、LDL-C和TG水平比较,差异有统计学意义（P＜0.05,P＜0.01）.男性低HDL-C患者1年预后不良发生率明显高于正常HDLC患者（27.9％ vs 24.1％,P＜0.05）.低HDL-C是男性脑卒中1年预后不良的独立危险因素（OR=1.289,95％CI：1.068～1.555,P=0.008）.基线LDL-C＜2.59 mmol/L患者中,低HDL-C水平仍是男性脑卒中患者1年预后不良的独立危险因素（OR=1.528,95％CI：1.162～2.010,P=0.002）.结论 低HDL-C是男性缺血性脑卒中患者发病1年预后不良的独立危险因素,并且独立于基线LDLC水平.LDL-C水平越低,升高HDL-C的临床获益越大.Objective To analyze the relation between low HDL-C and 1-year outcome in patients with acute ischemic stroke （AIS）.Methods A total of 8876 patients （5555 males and 3321 females） admitted to our hospital who met the diagnostic criteria for AIS in China National Stroke Registry were included in this study.The patients were divided into HDL-C＜0.9 mmol/L group （n=1440） and HDL-C≥0.9 mmol/L group （n=7436）.Effect of low HDL-C on the 1-year outcome in AIS patients was analyzed by multiple logistic regression analysis.Results The incidence of low HDL-C was 16.2％ in the 8867 AIS patients.The bascline blood pressure,serum LDL-C and TG levels were significantly different between the two groups （P＜0.05,P＜0.01）.The 1-year outcome was significantly poorer in male patients with their serum HDL-C level＜0.9 mmol/L than in those with their serum HDL-C level≥0.9 mmol/L （27.9％ vs 24.1％,P＜ 0.05）.low HDL-C was an independent risk factor for the 1-year poor outcome in male AIS patients （OR=1.289,95％ CI：1.068-1.555,P =0.008） and in those with their serum LDL-C level＜2.59 mmol/L （OR=1.528,95％CI：1.162-2.010,P=0.002）.Conclusion Low HDL-C is an independent risk factor for the 1-year year poor outcome in male AIS patients,which is independent of the baseline LDL-C level.The lower the LDL-C level is,the greater the clinical benefit of HDL-C level is.

关 键 词：高胆固醇血症 卒中 胆固醇 HDL 血脂异常 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]