血脂代谢与缺血性脑卒中患者脑出血转化的相关性研究  

Study on the relationship between lipid metabolism and cerebral hemorrhage transformation in the patients with ischemic stroke

作　　者：周苗[1] 庞国防[1] 姜蔼玲[1] 李宁虎[1] 陈梓斌[1] 秦娇琴[1] 黄澄[1] 黎祖越[1] 李嫦[1] 黄一鲜[1] 

机构地区：[1]广西壮族自治区江滨医院神经内三科,广西南宁530021

出　　处：《中国现代医生》2016年第28期1-4,8,共5页China Modern Doctor

摘　　要：目的研究血脂代谢与缺血性脑卒中患者脑出血转化(hemorrhagic transformation,HT)的关系,为有效防治HT提供依据。方法分别收录患者入院血压及生化指标(空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、梗死面积、是否皮质梗死等临床资料进行单因素分析,再对单因素分析中有统计学意义的相关因素进行多因素Logistic回归分析。结果 HT组总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)较低,收缩压、空腹血糖水平较高,与非脑梗死后出血转化(not hemorrhagic transformation,NHT)比较差异有统计学意义(P<0.05)。将血脂水平百分位数分组后经统计分析得出空腹TC、LDL-C水平和HT密切相关,随着空腹血清TC、LDL-C水平下降,HT发病率呈升高趋势。多因素Logistic回归分析结果提示梗死面积、空腹血糖、收缩压、总胆固醇、低密度脂蛋白胆固醇是急性脑梗死后HT的独立危险因素。结论血清低TC、低LDL-C与HT密切相关,随着空腹血清TC、LDL-C水平降低,HT发生率呈升高趋势。Objective To study the relationship between blood lipid metabolism and cerebral hemorrhagic transforma- tion（HT） in the patients with ischemic stroke, and to provide evidence for effective prevention and treatment of HT. Methods The clinical data were collected, including blood pressure, biochemical parameters （fasting blood glucose, to- tal cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol）, infarction size and whether cortical infarct were observed, and univariate analysis was carried out. Multivariate logistic regression analysis was used to analyze the factors that were statistically significant in univariate analysis. Results Total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） were significantly lower in HT group than those in HT group （P〈0.05）, while SBP and fasting blood glucose were higher in HT group. There was statistically significant difference compared with not hemorrhagic transformation（NHT） （P〈0.05）. According to the statistical analysis after the grouping of lipid level percentage, the fasting TC and LDL-C levels were closely correlated with HT. With the decrease of fasting serum TC, LDL-C levels, the incidence of HT was increased. Multivariate Logistic regression analysis showed that infarct size, fasting blood glucose,systolic blood pressure, total cholesterol and low density lipoprotein cholesterol were independent risk factors of HT after acute cerebral infarction. Conclusion Low serum TC, low LDL-C and HT are closely related. With the decrease of fasting serum TC, LDL-C levels, incidence of HT is in an increasing trend.

关 键 词：脑梗死 出血转化 总胆固醇 低密度脂蛋白胆固醇 

分 类 号：R743.3[医药卫生—神经病学与精神病学]