中老年血浆低密度脂蛋白亚型水平与后循环缺血的关联性分析  

Association between plasma low density lipoprotein subtype level andposterior circulation ischemia in the middle-aged and elderly patients

作　　者：孙常秀 陶洋[1] 丁金国[1] 顾红兵[1] SUN Changxiu;TAO Yang;DING Jinguo;GU Hongbing(Department of Clinical Laboratory,the Affiliated People′s Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China)

机构地区：[1]江苏大学附属人民医院检验科,江苏镇江212002

出　　处：《江苏大学学报(医学版)》2025年第2期166-170,179,共6页Journal of Jiangsu University:Medicine Edition

基　　金：镇江市社会发展指导性科技计划项目(FZ2023058)。

摘　　要：目的:探讨中老年人群血浆低密度脂蛋白(low-density lipoprotein,LDL)亚型水平与后循环缺血(posterior circulation ischemia,PCI)的关联性。方法:共纳入2023年1月至2024年5月于江苏大学附属人民医院就诊的中老年PCI患者168例,依据磁共振弥散加权成像的梗死改变情况,分为短暂性脑缺血发作(transient ischemic attack,TIA)组(83例)及脑梗死组(85例),另随机选取同期在本院体检的81例中老年健康受试者作为对照组。收集三组的一般资料,测定血浆高密度脂蛋白、中间密度脂蛋白及LDL亚型水平;采用Logistic回归分析中老年PCI发生的影响因素;运用受试者工作特征(ROC)曲线评价血浆LDL-3、LDL-4水平对中老年PCI的诊断价值。结果:与对照组相比,TIA组和脑梗死组的血浆LDL-3和LDL-4水平明显升高(P<0.05),高血压比例明显增加(P<0.05),而LDL-1水平明显降低(P<0.05);与对照组相比,脑梗死组的吸烟者比例、糖尿病比例、三酰甘油水平均明显升高(P<0.05)。Logistic回归显示,高血压(OR=2.114,95%CI:1.024~4.364,P<0.05)、血浆LDL-3(OR=1.006,95%CI:1.003~1.009,P<0.001)和LDL-4(OR=1.007,95%CI:1.002~1.013,P<0.05)是中老年PCI发生的独立危险因素,而血浆LDL-1(OR=0.402,95%CI:0.201~0.806,P<0.05)是PCI的独立保护因素。血浆LDL-3、LDL-4的ROC曲线下面积(AUC)分别为0.847、0.798,敏感度分别为86.9%、70.8%,特异度分别为72.8%、86.4%,两指标联合诊断的AUC为0.853。结论:血浆LDL-3和LDL-4水平升高,以及LDL-1水平降低,均与中老年PCI发生呈一定的关联性。Objective:To investigate the association between plasma low-density lipoprotein(LDL)subtypes and posterior circulation ischemia(PCI)in the middle-aged and elderly patients.Methods:A total of 168 middle-aged and elderly PCI patients who were treated in the Affiliated People′s Hospital of Jiangsu University from January 2023 to May 2024 were included.According to the infarct changes of magnetic resonance diffusion-weighted imaging,they were divided into transient ischemic attack(TIA)group(83 cases)and cerebral infarction group(85 cases).In addition,81 middle-aged and elderly healthy subjects who underwent physical examination in the hospital during the same period were randomly selected as the control group.The general data of the three groups were collected,and the levels of high-density lipoprotein,intermediate density lipoprotein,and LDL subtypes were measured.Logistic regression analysis was used to analyze the influencing factors of posterior circulation ischemia in middle-aged and elderly patients.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of plasma LDL-3 and LDL-4 levels for PCI in middle-aged and elderly patients.Results:Compared with the control group,the levels of plasma LDL-3 and LDL-4 and the proportion of hypertension in TIA group and cerebral infarction group were significantly increased(P<0.05),while the level of LDL-1 was significantly decreased(P<0.05).Compared with the control group,the proportion of smoking and diabetes,and the level of triacylglycerol(TG)were significantly increased in cerebral infarction group(P<0.05).Logistic regression showed that hypertension(OR=2.114,95%CI:1.024-4.364,P<0.05),plasma LDL-3(OR=1.006,95%CI:1.003-1.009,P<0.001)and LDL-4(OR=1.007,95%CI:1.002-1.013,P<0.05)were independent risk factors for PCI in middle-aged and elderly patients,while plasma LDL-1(OR=0.402,95%CI:0.201-0.806,P<0.05)was an independent protective factor for PCI.The area under the ROC curve(AUC)of plasma LDL-3 and LDL-4 was 0.847 and 0.798,the sensitivi

关 键 词：后循环缺血 低密度脂蛋白亚型 脑梗死 小而密低密度脂蛋白(sdLDL) 

分 类 号：R743[医药卫生—神经病学与精神病学]