载脂蛋白B与载脂蛋白A-Ⅰ比值联合颈动脉内膜-中层厚度预测急性脑梗死价值研究  

Predictive value of apolipoprotein B to apolipoprotein A-Ⅰratio combined with carotid intima-media thickness in acute cerebral infarction

作　　者：匡俊鑫 刘志强[2] 韩登峰[3] KUANG Junxin;LIU Zhiqiang;HAN Dengfeng(Department of Neurology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]暨南大学第一临床医学院神经内科,广东广州510000 [2]新疆医科大学第一附属医院心内科,新疆乌鲁木齐830000 [3]新疆医科大学第一附属医院神经内科,新疆乌鲁木齐830000

出　　处：《中风与神经疾病杂志》2022年第11期970-976,共7页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金(No.81760062)。

摘　　要：目的探讨载脂蛋白B与载脂蛋白A-Ⅰ比值联合颈动脉内膜-中层厚度预测急性脑梗死的价值。方法选取2020年7月-2021年6月在新疆医科大学第一附属医院神经内科住院的前循环急性大动脉粥样硬化型脑梗死患者作为病例组,随机选取同期住院的非心脑血管疾病患者作为对照组。比较两组的临床资料及实验室结果,分析急性脑梗死的危险因素,探究载脂蛋白B与载脂蛋白A-Ⅰ比值联合颈动脉内膜-中层厚度在脑梗死发病上的预测价值。比较两组的临床资料及实验室结果,用Logistic回归分析急性脑梗死发生的影响因素,并用受试者工作特征曲线(ROC)分析载脂蛋白B与载脂蛋白A-Ⅰ比值联合颈动脉内膜-中层厚度在脑梗死发病上的预测价值。结果研究纳入了143例急性脑梗死患者和122例非心脑血管疾病患者。多因素分析结果显示吸烟(OR=3.448,95%CI 1.609~7.391)、糖尿病(OR=2.884,95%CI 1.389~5.989)、颈动脉内膜-中层厚度(OR=1.633,95%CI 1.219~2.189)、白细胞(OR=1.258,95%CI 1.036~1.527)、游离脂肪酸(OR=14.113,95%CI 1.942~102.558)、载脂蛋白B与载脂蛋白A-Ⅰ比值(OR=10.896,95%CI 2.290~51.846)、D-二聚体(OR=4.690,95%CI 2.097~10.488)、同型半胱氨酸(OR=9.594,95%CI 1.112~82.772)是大动脉粥样硬化型脑梗死的独立危险因素。利用受试者工作特征曲线分析载脂蛋白B与载脂蛋白A-Ⅰ比值和颈动脉内膜-中层厚度联合预测急性脑梗死的价值,结果显示曲线下面积为0.757(95%CI 0.699~0.816),最佳预测值为0.466,灵敏度为81.8%,特异性为58.2%。结论载脂蛋白B与载脂蛋白A-Ⅰ比值、颈动脉内膜-中层厚度与前循环大动脉粥样硬化型脑梗死有关,它们在联合预测脑梗死的发病上有一定的价值。Objective To investigate the value of apolipoprotein B to apolipoprotein A-Ⅰratio combined with carotid intima-media thickness in predicting acute cerebral infarction.Methods Patients with acute large artery atherosclerotic cerebral infarction in the anterior circulation who were hospitalized in the Department of Neurology,The First Affiliated Hospital of Xinjiang Medical University from July 2020 to June 2021 were selected as the case group.Patients with non-cardiovascular and cerebrovascular diseases who were hospitalized during the same period were randomly selected as the control group.The clinical data and laboratory results of the two groups were compared,and the risk factors of acute cerebral infarction were analyzed.To explore the predictive value of apolipoprotein B to apolipoprotein A-Ⅰratio combined with carotid intima-media thickness in the incidence of cerebral infarction.The clinical data and laboratory results of the two groups were compared.The influencing factors of acute cerebral infarction were analyzed by logistic regression.The receiver operating characteristic curve was used to analyze the predictive value of the ratio of apolipoprotein B to apolipoprotein A-Ⅰcombined with carotid intima-media thickness in the incidence of cerebral infarction.Results The study included 143 patients with acute cerebral infarction and 122 patients with non-cardiovascular and cerebrovascular diseases.Multivariate analysis showed that smoking(OR=3.448,95%CI 1.609-7.391),diabetes(OR=2.884,95%CI 1.389-5.989),carotid intima-media thickness(OR=1.633,95%CI 1.219-2.189),Leukocytes(OR=1.258,95%CI 1.036-1.527),free fatty acids(OR=14.113,95%CI 1.942-102.558),ratio of apolipoprotein B to apolipoprotein AI(OR=10.896,95%CI 2.290-51.846),D-Dimer(OR=4.690,95%CI 2.097-10.488),homocysteine(OR=9.594,95%CI 1.112-82.772)were independent risk factors for large atherosclerotic cerebral infarction.The value of the ratio of apolipoprotein B to apolipoprotein A-Ⅰand carotid intima-media thickness in predicting acute cerebral in

关 键 词：脑梗死 载脂蛋白B与载脂蛋白A-Ⅰ比值 内膜-中层厚度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]