血脂水平与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的相关性  

Relationship of serum lipid with delayed cerebral ischemia following the aneurysmal subarachnoid hemorrhage

作　　者：王世龙[1] 赵冬[1] 许晖[1] 朱立仓[1] 刘祺[1] 何学君 王业忠[1] 

机构地区：[1]石河子大学医学院第一附属医院神经外科,新疆石河子832008

出　　处：《中国临床神经外科杂志》2016年第11期685-688,共4页Chinese Journal of Clinical Neurosurgery

基　　金：国家科技支撑计划(2013BAI05B05)

摘　　要：目的探讨血脂水平与动脉瘤性蛛网膜下腔出血(a SAH)后迟发性脑缺血(DCI)的相关性。方法回顾性分析2014年1月至2015年12月收治的74例a SAH的临床资料,采用多因素Logistic回归分析检验性别、年龄、动脉瘤位置、动脉瘤大小、世界神经外科医师联盟(WFNS)分级、改良Fisher分级、Hunt-Hess分级、治疗方式、总甘油三脂、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)、载脂蛋白A、载脂蛋白B等因素与DCI的关系。结果 74例中,65例入院后检测血脂,20例出现DCI,45例未出现DCI,a SAH后DCI的发生率为30.8%。多因素Logistic回归分析显示高甘油三酯及改良Fisher分级是a SAH后DCI发生的独立危险因素。结论及时检测a SAH患者的血脂水平和对患者进行改良Fisher分级对DCI的诊断治疗均有参考价值。Objective To explore the relationship between delayed cerebral isehemia （DCI） following the aneurysmal subarachnoid hemorrhage （aSAH） and serum level of lipid. Methods The clinical data of 74 patients with aSAH treated from January, 2014 to December, 2015 were analyzed retrospectively, including sex, age, location of aneurysms, size of aneurysms, World Federation of Neurosurgical Societies （WFNS） grade, modified Fisher grade, Hunt-Hess grade, treatment method, total and serum levels of triglyceride （TG）, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, lipoprotein（a）, apolipoprotein A and apolipoprotein B. The relationship of the DCI with the above-mentioned factors was analyzed by single factor analysis and Logistic regression. Results Of 65 patients receiving the determination of serum lipid, 20 （30.8%） suffered from DCI and 45 did not. The single factor analysis showed that the serum level of TG was statistically higher and the percentage of the patients with modified Fisher grades 0, 1 and 2 was statistically lower in the patients with DCI than those in the patients without DCI （P〈0.05）. Logistic regression analysis showed that high serum TG level and low modified Fisher grade were risk factors of DCI following the aSAH. Discussion It is suggested that DCI easily occurred in the patients with high serum levels of TG and low modified Fisher grades following the aSAH.

关 键 词：动脉瘤性蛛网膜下腔出血 迟发性脑缺血 血脂 改良Fisher分级 

分 类 号：R743.9[医药卫生—神经病学与精神病学]