摘要
目的 探讨老年急性脑梗死(ACI)患者血清低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、脂蛋白残粒胆固醇(RLP-C)及小而密低密度脂蛋白胆固醇(sdLDL-C)与颈动脉粥样硬化(CAS)程度的相关性.方法 选取2021 年1 月—2022 年1 月收治的105 例老年ACI为研究对象,根据CAS程度分为正常组18 例、增厚组30 例、斑块组57 例.比较不同CAS程度、不同斑块性质、不同梗死体积患者入院时血清LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C水平及与CAS程度、斑块性质、梗死体积相关性.受试者工作特征曲线分析血清各指标对CAS程度的预测价值.结果 与正常组比较,增厚组、斑块组血清LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C水平升高,且斑块组高于增厚组(P＜0.05);与稳定斑块组比较,不稳定斑块组血清LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C水平升高(P＜0.05);与低梗死组比较,中高梗死组血清 LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C水平升高(P＜0.05).LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C分别与CAS程度、斑块性质、梗死体积呈正相关(P＜0.05,P＜0.01);联合预测 CAS 程度的曲线下面积最大.结论 老年 ACI 患者血清LDL-C/HDL-C、non-HDL-C、RLP-C、sdLDL-C水平随着CAS程度增加而升高,其水平变化可反映病情发展,联合检测上述指标对CAS程度具有较高预测价值,可为临床早期判断病情进展及治疗提供新思路.
Abstract
Objective To investigate the correlation between serum low-density lipoprotein cholesterol/high-density lipoprotein cholesterol(LDL-C/HDL-C),non-high-density lipoprotein cholesterol(non-HDL-C),residual lipoprotein choles-terol(RLP-C),small dense low-density lipoprotein cholesterol(sdLDL-C)and degree of carotid atherosclerosis(CAS).Methods A total of 105 elderly patients with ACI admitted from January 2021 to January 2022 were retrospectively selected as the research subjects.According to the degree of CAS,they were divided into normal group(n =18),thickening group(n =30)and plaque group(n =57).The levels of serum LDL-C/HDL-C,non-HDL-C,RLP-C,and sdLDL-C in patients with different CAS degree,plaque nature and infarct volume were compared on admission and their correlation with CAS de-gree,plaque nature and infarct volume.The predictive value of serum indicators to CAS degree was analyzed by receiver oper-ating characteristic curve.Results Compared with normal group,the serum levels of LDL-C/HDL-C,non-HDL-C,RLP-C and sdLDL-C were increased in thickening group and plaque group,and higher in plaque group than in thickening group(P＜0.05).Compared with stable plaque group,serum levels of LDL-C/HDL-C,RLP-C and sdLDL-C in unstable plaque group were increased(P＜0.05).Compared with the low infarction group,the serum levels of LDL-C/HDL-C,non-HDL-C,RLP-C and sdLDL-C in the moderate and high infarction group were increased(P＜0.05).LDL-C/HDL-C,non-HDL-C,RLP-C and sdLDL-C were positively correlated with CAS degree,plaque nature and infarct volume,respectively(P＜0.05,P＜0.01).The joint prediction of CAS degree has the largest area under the curve.Conclusion Serum LDL-C/HDL-C,non-HDL-C,RLP-C,and sdLDL-C increased with the increase of CAS degree in elderly ACI patients,and the changes in their levels could reflect the development of the disease.Combined detection of the above indicators has a high predictive value for CAS degree,and can provide new ideas for early clinical diagnosis of disease progression and treatment.
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