颈动脉粥样硬化斑块患者同型半胱氨酸、低密度脂蛋白胆固醇/淋巴细胞比值与脑卒中风险的关系研究  

Association of homocysteine and low-density lipoprotein cholesterol to lymphocyte ratio with stroke risk in patients with carotid atherosclerotic plaque

作　　者：朱政羽 张慧和 王逸如 李玮 吴志敏[1] 吴旭杰 赵娜[1] ZHU Zhengyu;ZHANG Huihe;WANG Yiru;LI Wei;WU Zhimin;WU Xujie;ZHAO Na(Department of Neurology,Wenzhou TCM Hospital of Zhejiang Chinese Medicine University,Wenzhou 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院神经内科,325000

出　　处：《心电与循环》2025年第2期173-176,共4页Journal of Electrocardiology and Circulation

基　　金：温州市基础性医疗卫生科技项目(Y2020888)。

摘　　要：目的探讨颈动脉粥样硬化斑块患者同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL-C)/淋巴细胞(LYM)比值与脑卒中风险的关系。方法回顾性选择2019年1月至2023年1月温州市中医院收治的179例颈动脉粥样硬化斑块患者,根据2年内是否发生脑卒中分为观察组46例和对照组133例,比较两组患者的一般资料,采用多因素logistic回归分析脑卒中风险的影响因素,采用ROC曲线分析血液指标预测脑卒中风险的价值。结果观察组患者年龄、易损斑块占比、LDL-C、Hcy、LDL-C/LYM高于对照组,他汀药物治疗比例、LYM水平低于对照组,差异均有统计学意义(均P<0.05)。年龄、他汀药物治疗、斑块稳定性、LDL-C、Hcy、LDL-C/LYM均是颈动脉粥样硬化斑块患者发生脑卒中的独立影响因素(均P<0.05)。Hcy、LDL-C/LYM预测脑卒中风险的AUC分别为0.783、0.753。结论Hcy和LDL-C/LYM或可辅助预测颈动脉粥样硬化斑块患者脑卒中风险。Objective To investigate the association of homocysteine(Hcy)and low-density lipoprotein cholesterol to lymphocyte ratio(LDL-C/LYM)with stroke risk in patients with carotid atherosclerotic plaque(CASP).Methods A total of 179 CASP patients admitted to Wenzhou TCM Hospital of Zhejiang Chinese Medicine University from January 2019 to January 2023 were retrospectively selected and divided into an observation group(46 cases)and a control group(133 cases)according to whether occurrence of stroke within 2 years.The clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the influencing factors for stroke.ROC curve was used to analyze the value of laboratory measures in predicting stroke risk.Results The age,proportion of vulnerable plaque,LDL-C,Hcy and LDL-C/LYM in the observation group were higher than those in the control group,and the proportion of statin therapy and LYM level were lower than those in the control group,with statistical significance for all(all P<0.05).Age,statin therapy,plaque stability,LDL-C,Hcy and LDL-C/LYM were independent influencing factors for stroke(all P<0.05).The AUC of Hcy and LDL-C/LYM in predicting stroke risk were 0.783 and 0.753.Conclusion Hcy and LDL-C/LYM can predict the risk of stroke in patients with CASP.

关 键 词：颈动脉粥样硬化 脑卒中 同型半胱氨酸 低密度脂蛋白胆固醇 低密度脂蛋白胆固醇与淋巴细胞比值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]