Implications of dynamic measurement of LDL-C,HDL-C and their ratios in the prognosis of patients with acute cerebral infarction undergoing thrombolysis
Objective:To dynamically measure the level of low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and their ratios in estimation of the prognosis of thrombolytic patients with acute cerebral infarction(ACI).Methods:Retrospective analysis was conducted on the clinical data of 121 ACI patients who received rt-PA intravenous thrombolysis treatment in the Neurology Department of Taihe County People's Hospital from January 2020 to December 2022.The cases were divided into a poor prognosis group(n=33)and a good prognosis group(n=88)based on their 90 day mRS score.LDL-C and HDL-C levels were measured on the first day of thrombolysis and one month after thrombolysis,and the differences in levels between the two groups were compared.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the above indicators.Results:In univariate analysis,the NIHSS score,infarct volume,time from onset to thrombolysis,and the proportion of concomitant hypertension in the poor prognosis group were higher than those in the good prognosis group,and the body mass index were lower than those in the good prognosis group(all P＜0.05).After 1 day of thrombolysis,the LDL-C and LDL-C/HDL-C ratios of both groups of patients were decreased,whereas the HDL-C values were increased(P＜0.05),and HDL-C increase in the good prognosis group was significantly higher than that in the poor prognosis group(P＜0.05).The results of multivariate logistic regression analysis showed that low body mass index(OR=0.730,95％CI:0.552-0.966),large infarct volume(OR=1.088,95％CI:1.014-1.167),long time from onset to thrombolysis(OR=1.012,95％CI:1.000-1.023),concomitant hypertension(OR=4.911,95％CI:1.599-15.083),and low HDL-C difference(OR=0.753,95％CI:0.571-0.992)were independent risk factors for poor prognosis in ACI patients(P＜0.05).The ROC results indicated the area under the HDL-C difference prediction curve being 0.718(P＜0.05).Conclusion:Dynamic measurement of the levels of HDL-C has important clinical value in predicting poor prognosis in ACI patients after intravenous thrombolysis.
acute cerebral infarctionhigh density lipoprotein cholesterollow density lipoprotein cholesterollow density lipoprotein cholesterol/high density lipoprotein cholesterolpredictive value
万方数据
维普
