高密23.度脂蛋白胆固醇水平与脑血29栓.患者全因死亡相关  

The Levels of High Density Lipoprotein Cholesterol are Associated with All-cause Mortality of Cerebral Thrombosis Patients

作　　者：柳婷婷[1] 张银辉[1] 张禅那[1] 宋莉[1] 宋燕[1] 惠汝太 陈敬洲[1] 

机构地区：[1]北京协和医学院中国医学科学院国家心血管病中心阜外医院心血管疾病国家重点实验室,北京市100037

出　　处：《中国分子心脏病学杂志》2017年第2期2037-2040,共4页Molecular Cardiology of China

基　　金：973项目(2014CB541601)

摘　　要：目的研究表明高密度脂蛋白胆固醇(High Density Lipoprotein cholesterol,HDL-C)水平可以独立预测脑卒中的不良预后和复发,然而HDL-C水平与脑卒中亚型脑血栓的结局关系仍然不明确,本研究的目的是分析脑血栓患者HDL-C水平与全因死亡的相关性。方法我们于2000年至2001年共纳入768例脑血栓患者并平均随访4.5年,其中男性489例(63.7%),平均年龄(61.6±9.2)岁。根据患者入院时HDL-C浓度四分位值将患者分为四组,即HDL-C浓度第1分位(HDL-C≤0.72mmol/L)组(Q1组,n=182),HDL-C浓度第2分位(0.72<HDL-C≤0.86mmol/L)组(Q2组,n=214),HDL-C浓度第3分位(0.86<HDL-C≤1.00mmol/L)组(Q3组,n=196),HDL-C浓度第4分位(HDL-C>1.00mmol/L)组(Q4组,n=176)。收集患者入院时的基线资料及静脉血标本,检测血糖,甘油三酯,总胆固醇以及高密度脂蛋白胆固醇等值,终点事件定义为全因死亡。结果 768例脑血栓患者总全因死亡率为20.4%(157/768)。以Q1组为基准进行计算,Q2(16.8%,36/214)、Q3(18.9%,37/196)组患者全因死亡率低于Q1组(27.5%,50/182),差异均有统计学意义(P<0.05),但是Q4组(19.3%,34/176)患者全因死亡率与Q1组(27.5%,50/182)相比无统计学意义(P>0.05)。在调整了年龄,性别等影响预后因素后,Q2(HR=0.535,95%CI=0.343-0.835,P=0.006)、Q3(HR=0.409,95%CI=0.255-0.65,P<0.001)、Q4(HR=0.497,95%CI=0.298-0.828,P=0.007)较Q1组均对脑血栓患者全因死亡具有保护作用。结论高密度脂蛋白胆固醇水平与脑血栓患者全因死亡相关。Objective Studies had shown that high density lipoprotein cholesterol levels could independently predict the poor prognosis and recurrence of stroke. However, the relationship between HDL-C levels and the cerebral thrombus was still unclear. The purpose of this study was to investigate the relationship between HDL- C levels and all-cause mortality in cerebral thrombosis patients. Methods A total of 768 cerebral thrombosis patients were recruited during 2000-2001 and prospectively followed up for a median of 4.5 years. There were 489 （63.7%） male and the average age were （61.64-9.2）. According to admission HDL- C concentrations, the patients were divided into 4 groups：Ql group, HDL- C concentrations ≤0.72mmol/L, n=182, Q2 group, HDL-C concentrations（0.72 〈 HDL-C≤0.86mmol/L）, n=214, Q3 group, HDL-C concentrations（0.86 〈 HDL-C≤1.00mmol/L）, n=196, Q4 group, HDL- C concentrations 〉 1.00mmol/L, n=176. The basic information was collected in all groups, the primary endpoint was all-cause mortality. Results The total all-cause mortality in the 768 patients with cerebral thrombosis was 20.4% （157/768）. QI group was calculated to be set as a reference. The all-cause mortality in Q2 （16.5%, 36/142） and Q3 （18.9%, 37/196） group were lower than that in Q1（27.5%, 50/182）group, the difference was statistically significant （P 〈0.05）, but the all- cause mortality in Q4 （19.3%, 34/176） group was no significant difference to that in Q1（27.5%, 50/182） group（P〉 0.05）. With adjusted age, gender and other relevant factors, compared with Q1, Q2（HR=0.535,95%CI=0.343-0.835, P=0.006）, Q3（HR=0.409,95%CI=0.255-0.65, P〈0.001）and Q4（HR=0.497,95%CI=0.298-0.828, P=0.007）groups had a protective role on all-cause mortality in cerebral thrombosis patient. Conelusions The levels of high density lipoprotein cholesterol were associated with all-cause mortality of cerebral thrombosis patients.

关 键 词：高密度脂蛋白胆固醇 脑血栓 全因死亡 

分 类 号：R743.32[医药卫生—神经病学与精神病学]