急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究  

Study on the Correlation between Low Density Lipoprotein(LDL)Cholesterol Level and the Severity of Cardiovascular and Cerebrovascular Stenosis in Patients with Acute Ischemic Stroke

作　　者：韩晶晶 杨帆[2] 周旭强 陆怡德[1] HAN Jing-jing;YANG Fan;ZHOU Xu-qiang;LU Yi-de(Department of Clinical Laboratory,Wuxi Branch of Ruijin Hospital,Medical College of Shanghai Jiaotong University,Jiangxi Wuxi 214000,China;Department of Clinical Laboratory,Ruijin Hospital of Medical College,Shanghai Jiaotong University,Shanghai 200025,China;Department of Clinical Laboratory,Wujiang District Hospital of Combining Chinese and Western Medicine,Jiangsu Suzhou 215200,China)

机构地区：[1]上海交通大学医学院附属瑞金医院无锡分院检验科,江苏无锡214000 [2]上海交通大学医学院附属瑞金医院检验科,上海200025 [3]苏州市吴江区中西结合医院检验科,江苏苏州215200

出　　处：《现代检验医学杂志》2020年第3期42-46,共5页Journal of Modern Laboratory Medicine

摘　　要：目的研究急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇(small and low density lipoprotein cholesterol,sdLDL-C)与心脑血管狭窄程度的相关性。方法收集上海市交通大学附属瑞金医院神经内科2015年5月~2017年10月期间,已确诊为缺血性脑卒中患者146例。按照其血管造影(MRA)和颈部超声结果,分为血管正常组18例、血管闭塞组34例和血管狭窄组94例(包括血管单支狭窄组28例、血管多支狭窄组66例),分别检测其血清胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[Lp(a)]和小而密低密度脂蛋白胆固醇(sdLDL-C)水平。另选取对照组112例。比较各组间sdLDL-C的检测结果,并用多元logistic回归分析各检测项目与急性缺血性脑卒中的关系。结果病例组中TG,Lp(a)和sdLDL-C明显高于对照组,差异均具有统计学意义(t=-6.011,-2.776,-3.744,均P<0.05);对照组的HDL-C明显高于病例组,差异具有统计学意义(t=9.665,P<0.05);TG,Lp(a),sdLDL-C和sdLDL-C/LDL-C比值与急性缺血性脑卒中的发生呈正相关(相关系数分别为0.316,0.166,0.20,0.243);血管闭塞组sdLDL-C的血清水平(33.77±14.57mmol/L)明显高于血管正常组sdLDL-C的血清水平(25.38±12.29mmol/L);血管多支狭窄组sdLDL-C的血清水平(30.10±13.61 mmol/L)明显高于单支狭窄组(20.88±6.46 mmol/L);血管闭塞组LDL-C,sdLDL-C明显高于血管正常组和血管狭窄组,差异具有统计学意义(F=3.34,3.719,均P<0.05);多支狭窄组血清TG,TG,LDL-C,sdLDL-C和sdLDL-C/LDL-C结果均高于单支狭窄组,差异均具有统计学意义(t=-3.381,-2.372,-2.17,-4.323,-2.193,均P<0.05)。结论急性缺血性脑卒中患者sdLDL-C水平升高,且升高水平与血管病变程度密切相关。Objective To study the value of small and low density lipoprotein cholesterol(sdLDL-C)in the diagnosis of patients with acute ischemic stroke and its correlation with other risk factors in the occurrence of acute ischemic stroke.Methods From May 2015 to October 2017,146 patients with ischemic stroke were collected in the Department of Neurology,Ruijin Hospital Affiliated to Shanghai Jiaotong University.According to the results of MRA and neck ultrasound,the patients were divided into normal vascular group(18 cases),occluded vascular group(34 cases)and stenotic vascular group(94 cases:single vessel stenosis group/28 cases and multi vessel stenosis group/66 cases).The levels of TC,TG,HDL-L,LDL-C,Lp(a)and sdLDL-C were measured.In the control group,112 healthy people were selected to test the sdLDL-C level studied in this experiment,and the correlation between sdLDL-C and acute ischemic stroke was explored.Results TG,Lp(a)and sdLDL-C in the case group were significantly higher than those in the control group,with statistically significant differences(t=-6.011,-2.776,-3.744,all P<0.05).HDL-C in the control group was significantly higher than that in the case group,with statistically significant difference(t=9.665,P<0.05).TG,Lp(a),sdLDL-C and sdLDL-C/LDL-C ratios were positively correlated with the occurrence of acute ischemic stroke(correlation coefficients were 0.316,0.166,0.20,and 0.243,respectively).The serum level of sdLDL-C in the occluded group(33.77±14.57mmol/L)was significantly higher than that in the normal vascular group(25.38±12.29mmol/L).The serum level of sdLDL-C in the multi-vessel stenosis group(30.10±13.61 mmol/L)was significantly higher than that in the single-vessel stenosis group(20.88±6.46 mmol/L).LDL-C and sdLDL-C in the vascular occlusion group were significantly higher than those in the normal vascular group and the vascular stenosis group(F=3.34,3.719,all P<0.05),with statistically significant differences.Results of serum TG,TG,LDL-C,sdLDL-C and sdLDL-C/LDL-C in the multibranch stenosis gro

关 键 词：小而密低密度脂蛋白胆固醇 急性缺血性脑卒中 心脑血管 狭窄程度 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R446.112[医药卫生—临床医学]