急性大脑中动脉闭塞患者非高密度脂蛋白胆固醇水平变化及其与软脑膜侧支循环的关系  

Relationship between non⁃high density lipoprotein cholesterol and leptomeningeal collaterals in patients with acute middle cerebral artery occlusion

作　　者：安怡 云艳芳 杨桂新 陈海燕[1] 蒋勇明 黄东旭 莫晓榕 李晓岚 韦宝莹 周莹杰 李雪斌[1] 黄建敏[1] AN Yi;YUN Yanfang;YANG Guixin;CHEN Haiyan;JIANG Yong-ming;HUANG Dongxu;MO Xiaorong;LI Xiaolan;WEI Baoyin;ZHOU Yingjie;LI Xuebin;HUANG Jianmin(Department of Neurology,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院神经内科,广西百色533000

出　　处：《实用医学杂志》2023年第24期3200-3204,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81860226)。

摘　　要：目的探讨非高密度脂蛋白胆固醇(non-HDL-C)表达水平与急性大脑中动脉闭塞患者软脑膜侧支(LMC)循环的相关性。方法使用回顾性研究方法,选取首次发病诊断明确的大脑中动脉M1段闭塞的急性缺血性脑卒中患者85例,根据脑血管造影(DSA)检查结果,按照美国介入和治疗放射学学会/介入放射学学会(ASITN/SIR)侧支循环评估系统对LMC循环进行评估,将患者分为LMC循环良好组30例(2-4级)和LMC循环不良组55例(0-1级),比较两组non-HDL-C水平。结果与LMC循环良好组比较,LMC循环不良组LDL-C、non-HDL-C水平均明显增高,差异有统计学意义(P=0.026,P=0.010)。二元logistic回归分析结果显示,non-HDL-C为LMC循环不良的危险因素(OR=3.019,95%CI:1.053~8.658,P=0.04)。LMC循环评分与血清non-HDL-C水平呈负相关(r=-0.228,P=0.036)。non-HDL-C表达水平预测LMC循环不良曲线下面积为0.638(95%CI:0.521~0.755,P=0.036)。结论non-HDL-C与急性脑梗死患者LMC循环不良具有显著相关性,成为LMC循环不良的危险因素,提示non-HDL-C水平增高可作为预测急性脑梗死患者LMC循环代偿不良的一项血清学指标。Objective To explore the relationship between non-high density lipoprotein cholesterol(non-HDL-C)level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion.Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled.According to the results of DSA,LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assess-ment System.All patients were assigned to better LMC circulation group(score 2~4,n=30)and worse LMC circulation group(score 0~1,n=55),and the levels of non-HDL-C were compared between the two groups.Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group(P=0.026,P=0.010).non-HDL-C was an independent risk factor for the worse LMC circulation(OR=3.019,95%CI:1.053~8.658,P=0.04).LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level(r=-0.228,P=0.036).The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638(95%CI:0.521~0.755,P=0.036).Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation,and was a risk factor for worse LMC circulation.It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

关 键 词：急性大脑中动脉闭塞 脑血管造影 非高密度脂蛋白胆固醇 软脑膜侧支循环 

分 类 号：R743.3[医药卫生—神经病学与精神病学]