急性缺血性卒中患者与血脂的相关性研究  

Study on the Correlation Between Acute Ischemic Stroke Patients and Blood Lipids

作　　者：陈光照 马田就[1] 唐春发[1] 蔡孟[1] 郑丽容[1] 罗吉 CHEN Guangzhao;MA tianjiu;TANG chunfa;CAI Meng;ZHENG lirong;LUO Ji(Department of Pharmacy,Guangdong Central Hospital of Reclamation,Zhanjiang Guangdong 524000)

机构地区：[1]广东省农垦中心医院药学部,广东湛江524000

出　　处：《智慧健康》2023年第31期13-16,共4页Smart Healthcare

基　　金：湛江市非资助科技攻关专题《急性脑卒中临床生化参数标志模型的研究》(项目编号:2021B01290)。

摘　　要：目的探讨急性缺血性脑卒中与血脂的相关性,研究急性缺血性脑卒中血脂参数模型的诊断预测价值。方法选取2021年5月—2022年6月收治的200例急性缺血性脑卒中患者作为研究对象,按照疾病类型的不同分为两组,首次缺血性脑卒中组(缺血性脑卒中)150例、复发脑卒中组(复发性缺血性脑卒中)50例,同期选择100例健康体检人员作为研究对象视为健康组,采用Logistic回归分析急性脑卒中发生及复发的血脂指标相关性分析,利用受试者工作特征曲线(ROC)评价血脂参数模型对急性缺血性脑卒中诊断的预测价值。结果①首次缺血性脑卒中组、复发脑卒中组和健康组三组血脂指标TCH、TG、HDL-C、LDL-C、apoB、TCH/HD-CL、LDL-C/HDL-C之间差异有统计学意义(P<0.05)。②首次缺血性脑卒中组的TCH、TG、LDL-C高于复发脑卒中组,HDL-C低于复发脑卒中组(P<0.05)。③Logistic回归分析TCH、TG、LDL-C、apoB、TCH/HDL-C、LDL-C/HDL-C为首次脑卒中及复发脑卒中的独立危险因素。④ROC显示:TCH/HDL-C模型诊断预测急性脑卒中的曲线下面积(areaunder curve,AUC)为0.766(95%CI:0.700~0.832),最佳截断值为3.91,灵敏度、特异度及约登指数分别为:82.3%、71.1%、0.534;LDL-C/HDL-C模型诊断预测脑卒中的AUC为0.754(95%CI:0.687~0.822),最佳截断值为2.38,灵敏度、特异度及约登指数分别为78.5%、67.2%、0.457。结论急性缺血性脑卒中的首次发生和复发与血清中TCH、TG、LDL-C、apoB、TCH/HDL-C、LDL-C/HDL-C水存在密切相关性。TCH/HDL-C、LDL-C/HDL-C两种模型联合可对急性脑卒中的首次发生有诊断及预测有参考价值。Objective To investigate the correlation between acute ischemic stroke and blood lipid,and to study the diagnostic and predictive value of lipid parameter model in acute ischemic stroke.Methods A total of 200 patients with acute ischemic stroke admitted from May 2021 to June 2022 were selected as study subjects and divided into two groups according to different disease types:the first ischemic stroke group(ischemic stroke)-150 cases,the recurrent stroke group(recurrent ischemic stroke)-50 cases,and 100 healthy physical examination personnel were selected as study subjects during the same period in the healthy group,Logistic regression analysis was used to analyze the correlation analysis of blood lipid indexes of acute stroke with very recurrent stroke,and the subjects were used Working characteristic curve(ROC)to evaluate the predictive value of lipid parameter model in the diagnosis of acute ischemic stroke.Results①There were statistically significant differences in TCH,TG,HDL-C,LDL-C,apoB,TCH/HD-CL,LDL-C/HDL-C among the first ischemic stroke group,recurrent stroke group and healthy group(P<0.05).②The TCH,TG and LDL-C of the first ischemic stroke were higher than those of the recurrent stroke group,and the HDL-C was lower than those of the recurrent stroke group(P<0.05).③Logistic regression analysis showed that TCH,TG,LDL-C,apoB,TCH/HDL-C,LDL-C/HDL-C were independent risk factors for first stroke and recurrent stroke.④ROC curve showed that the(areaunder curve AUC)of TCH/HDL-C model for diagnosis and prediction of acute stroke was 0.766(95%C1:0.700~0.832),the best cut off value was 3.91,sensitivity,specificity and Jorden index were 82.3%,71.1%,0.534,respectively.The predictive AUC of stroke diagnosis by LDL-C/HDL-C model was 0.754(95%C1:0.687~0.822),the best cut off value was 2.38,sensitivity,specificity and Jorden index were 78.5%,67.2%,0.457.Conclusion 1.The first occurrence and recurrence of acute ischemic stroke were closely correlated with TCH,TG,LDL-C,apoB,TCH/HDL-C and LDL-C/HDL-C water in serum.2

关 键 词：急性缺血性脑卒中 血脂 血脂参数模型 

分 类 号：R743.3[医药卫生—神经病学与精神病学]