胆固醇与高密度脂蛋白比值对冠心病患者发生缺血性脑卒中的预测价值  

Study on the predictive value of total cholesterol/high density lipoprotein cholesterol ratio for newonset ischemic stroke in patients with coronary heart disease

作　　者：张青云[1] 孙丹丹 王芬[1] 王全良[1] 王文青[1] 钱瑞娟 康杰[1] 胡同秀 梁涛[2] Zhang Qingyun;Sun Dandan;Wang Fen;Wang Quanliang;Wang Wenqing;Qian Ruijuan;Kang Jie;Hu Tongxiu;Liang Tao(DepartmentⅠof Cardiology,Affiliated Hospital of Jining Medical University,Jining 272100,China;School of Nursing,Peking Union Medical College,Beijing 100730,China)

机构地区：[1]济宁医学院附属医院心内一科,济宁272100 [2]北京协和医学院护理学院,100730

出　　处：《中华现代护理杂志》2021年第19期2596-2599,共4页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2019年护理学科研究课题(CMAPH-NRI2019019);济宁医学院教师科研扶持基金项目(JYFC2019FKJ080)。

摘　　要：目的探讨胆固醇与高密度脂蛋白比值(TC/HDL)对冠心病患者发生缺血性脑卒中的预测价值。方法采用整群抽样法,选取2017年1月1日—12月31日就诊于济宁医学院附属医院的1983例住院冠心病患者作为研究对象,收集其临床资料,并进行为期2年的随访,收集患者脑卒中发生情况。结果在2年随访期内,冠心病患者发生缺血性脑卒中36例,发生率为1.82%(36/1983)。男性冠心病患者TC/HDL与缺血性脑卒中的发生呈曲线关系,其折点为3.84,在TC/HDL<3.84时,TC/HDL与缺血性脑卒中的发生呈负相关,TC/HDL每增加一个单位,缺血性脑卒中发生率降低72%(P=0.049);在TC/HDL>3.84时,TC/HDL与缺血性脑卒中的发生无相关性(P=0.267)。女性冠心病患者TC/HDL与缺血性脑卒中的发生呈曲线关系,其折点为2.81,在TC/HDL<2.81时,TC/HDL与缺血性脑卒中的发生呈负相关,TC/HDL每增加一个单位,缺血性脑卒中发生率降低99%(P=0.019),在TC/HDL>2.81时,TC/HDL与缺血性脑卒中的发生无相关性(P=0.110)。结论TC/HDL在不同性别冠心病患者发生缺血性脑卒中的预测中具有不同的阈值,这对于预测冠心病患者预后具有一定的临床指导意义。Objective To investigate the predictive value of total cholesterol/high density lipoprotein cholesterol ratio(TC/HDL)for ischemic stroke in patients with coronary heart disease(CHD).Methods A total of 1983 inpatients with CHD in the Affiliated Hospital of Jining Medical University from January 1,2017 to December 31,2017 were selected as subjects by cluster sampling method.The clinical data were collected and followed up prospectively for 2 years.Results During the 2-year follow-up period,36 cases of ischemic stroke occurred in patients with CHD,and the incidence rate was 1.82%(36/1983).There was a curvilinear relationship between TC/HDL and ischemic stroke in male patients with CHD,and the tipping point was 3.84.When TC/HDL was less than 3.84,TC/HDL was negatively correlated with the incidence of ischemic stroke.The incidence of ischemic stroke decreased by 72%for each additional unit of TC/HDL(P=0.049).When TC/HDL was over 3.84,there was no correlation between TC/HDL and the incidence of ischemic stroke(P=0.267).There was a curvilinear relationship between TC/HDL and ischemic stroke in female patients with CHD,and the tipping point was 2.81.When TC/HDL was less than 2.81,TC/HDL was negatively correlated with the incidence of ischemic stroke.The incidence of ischemic stroke decreased by 99%for each additional unit of TC/HDL(P=0.019).When TC/HDL was over 2.81,there was no correlation between TC/HDL and the incidence of ischemic stroke(P=0.110).Conclusions TC/HDL has different thresholds in predicting ischemic stroke in CHD patients with different genders,which has a certain clinical significance in predicting the prognosis of patients with coronary heart disease.

关 键 词：冠心病 胆固醇与高密度脂蛋白比值 缺血性脑卒中 

分 类 号：R541.4[医药卫生—心血管疾病] R743.3[医药卫生—内科学]