中性粒细胞/高密度脂蛋白胆固醇比值和单核细胞/高密度脂蛋白胆固醇比值与急性缺血性卒中患者颈动脉斑块及其易损性的相关性  

Associations of neutrophil-to-high-density lipoprotein cholesterol ratio and monocyte-to-high-density lipoprotein cholesterol ratio with carotid plaque and its vulnerability in patients with acute ischemic stroke

作　　者：高珊 王艺璇 关欣颖 Gao Shan;Wang Yixuan;Guan Xinying(Department of Neurology,the Afiliated Lianyungang Hospital of Xuzhou Medical University,Lianyun-gang 222000,China)

机构地区：[1]徐州医科大学附属连云港医院神经内科,连云港222000

出　　处：《国际脑血管病杂志》2024年第11期839-844,共6页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金青年科学基金(82001171);江苏高校“青蓝工程”;连云港市科技计划(社会发展)项目(SF2114);连云港市卫生科技项目(202314)。

摘　　要：目的:探讨中性粒细胞/高密度脂蛋白胆固醇比值(neutrophil-to-high-density lipoprotein cholesterol ratio,NHR)和单核细胞/高密度脂蛋白胆固醇比值(monocyte-to-high-density lipoprotein cholesterol ratio,MHR)与急性缺血性卒中(acute ischemic stroke,AIS)患者颈动脉斑块及其易损性的相关性。方法:回顾性纳入2022年1月1日至2023年1月31日期间连云港市第一人民医院神经内科连续收治的首发AIS患者。根据入院后颈动脉超声结果分为无斑块组和斑块组,后者进一步分为稳定斑块组和易损斑块组。采用多变量logistic回归分析评估颈动脉斑块及其易损性的独立危险因素,并计算优势比(odds ratio,OR)及其95%置信区间(confidence interval,CI)。结果:纳入369例AIS患者,男性259例(70.20%),中位年龄63.00岁(四分位数间距56.00~70.00岁)。无斑块组20例(5.42%),斑块组349例(94.58%),其中稳定斑块组142例(40.69%),易损斑块组207例(59.31%)。多变量logistic回归分析显示,NHR较高(OR 2.558,95%CI 1.068~6.126;P=0.035)和MHR较高(OR 2.312,95%CI 1.111~4.814;P=0.025)是颈动脉斑块的独立危险因素;高龄(OR 1.069,95%CI 1.037~1.103;P<0.001)、饮酒(OR 2.072,95%CI 1.049~4.092;P=0.036)、NHR较高(OR 1.521,95%CI 1.146~2.019;P=0.004)和MHR较高(OR 1.765,95%CI 1.388~2.244;P<0.001)是颈动脉易损斑块的独立危险因素。结论:NHR和MHR较高与AIS患者颈动脉斑块及其易损性相关。Objective:To investigate associations of neutrophil-to-high-density lipoprotein cholesterol ratio(NHR)and monocyte-to-high-density lipoprotein cholesterol ratio(MHR)with carotid plaque and its vulnerability in patients with acute ischemic stroke(AIS).Methods:Consecutive patients with first-ever AIS admitted to the Department of Neurology,the First People's Hospital of Lianyungang from January 1,2022 to January 31,2023 were enrolled retrospectively.According to the carotid ultrasound findings after admission,they were divided into a non-plaque group and a plaque group.The latter was further divided into a stable plaque group and a vulnerable plaque group.Multivariate logistic regression analysis was used to evaluate the independent risk factors for carotid plaque and its vulnerability.The odds ratio(OR)and its 95%confidence interval(CI)were calculated.Results:A total of 369 patients with AIS were enrolled,including 259 males(70.20%),with a median age of 63.00 years(interquartile range,56.00-70.00 years).There were 20 patients(5.42%)in the non-plaque group and 349(94.58%)in the plaque group,including 142(40.69%)in the stable plaque group and 207(59.31%)in the vulnerable plaque group.Multivariate logistic regression analysis showed that higher NHR(OR 2.558,95%CI 1.068-6.126;P=0.035)and higher MHR(OR 2.312,95%CI 1.111-4.814;P=0.025)were the independent risk factors for carotid plaques;advanced age(OR 1.069,95%CI 1.037-1.103;P<0.001),alcohol consumption(OR 2.072,95%CI 1.049-4.092;P=0.036),higher NHR(OR 1.521,95%CI 1.146-2.019;P=0.004),and higher MHR(OR 1.765,95%CI 1.388-2.244;P<0.001)were the independent risk factors for vulnerable carotid plaques.Conclusion:Higher NHR and MHR are associated with carotid plaque and its vulnerability in patients with AIS.

关 键 词：缺血性卒中 颈动脉狭窄 斑块 动脉粥样硬化 胆固醇 HDL 中性粒细胞 单核细胞 超声检查 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]