残余胆固醇水平与急性脑梗死相关性探讨
Relationship between remnant cholesterol and acute ischemic stroke
张青青 1石秋艳 1王翠兰 1孙原 1李冬梅 1张春阳 1李弘 1许位1
作者信息
- 1. 华北理工大学附属医院神经内科,河北 唐山 063000
- 折叠
摘要
目的 探讨残余胆固醇(RC)与急性脑梗死的关系.方法 选取2022年10月至2023年10月在华北理工大学附属医院神经内科住院治疗的急性脑梗死患者208例为病例组,同期健康体检者208例为对照组,所有研究对象通过Friedewald方程计算RC值,通过二元logistics回归分析RC对急性脑梗死的影响,绘制ROC曲线评估RC预测急性脑梗死发病风险的效能.同时分析了不同RC水平及RC与LDL-C的不一致性与急性脑梗死的关系.结果 与对照组的临床资料比较发现,在控制其他因素后,RC是急性脑梗死的独立危险因素(OR=5.839,95%CI 2.225～15.325).ROC曲线分析结果显示,RC预测急性脑梗死发病风险的曲线下面积为0.692,特异度为74%,灵敏度为58.7%.RC与LDL-C的不一致性分析显示,与RC与LDL-C一致组相比,不一致高RC水平组的急性脑梗死发病风险升高2.140倍,而不一致低RC水平组具有一定的保护作用;与LDL-C≤3.4 mmol/L且RC≤0.62 mmol/L组比较,当LDL-C>3.4 mmol/L且RC≤0.62 mmol/L时急性脑梗死发病风险增加并不显著,而LDL-C≤3.4 mmol/L且RC>0.62 mmol/L时急性脑梗死发病风险升高3.210倍.分析不同RC水平与急性脑梗死的关系发现,RC Q4(≥0.92 mmol/L)发生急性脑梗死的风险是RC Q1(≤0.51 mmol/L)的4.334倍.结论 RC是急性脑梗死的独立危险因素,其作用独立于LDL-C的作用,RC水平越高,急性脑梗死发病风险越大.
Abstract
Objective To investigate the relationship between remnant cholesterol(RC)and acute ische-mic stroke.Methods A total of 208 patients with acute ischemic stroke admitted to the Department of Neu-rology,Affiliated Hospital of North China University of Science and Technology from October 2022 to Octo-ber 2023 were included as the case group.Concurrently,a total of 208 healthy individuals undergoing routine health check-ups served as the control group.RC values were calculated using the Friedewald equation for all study subjects.The impact of RC on acute ischemic stroke was analyzed using binary logistic regression,and the predictive efficacy of RC for the risk of acute ischemic stroke was evaluated by constructing ROC curves.The study also analyzed the relationship between different RC levels,inconsistencies between RC and LDL-C,and acute ischemic stroke.Results Comparative analysis of clinical data between the case and the control group revealed that,after controlling for other factors,RC(OR=5.839,95%CI 2.225-15.325)was an inde-pendent risk factor for acute ischemic stroke.ROC curve analysis showed that the area under the curve for RC predicting the risk of acute ischemic stroke was 0.692,with a specificity of 74%and sensitivity of 58.7%.A-nalysis of inconsistencies between RC and LDL-C indicated that compared to the consistent RC and LDL-C group,the inconsistent high RC level group had a 2.140-fold higher risk of acute ischemic stroke,while the in-consistent low RC level group exhibited a protective effect.Compared to the group with LDL-C≤3.4 mmol/L and RC≤0.62 mmol/L,the risk of acute ischemic stroke did not significantly increase when LDL-C was>3.4 mmol/L and RC≤0.62 mmol/L,whereas it increased by 3.210 times when LDL-C≤3.4 mmol/L and RC>0.62 mmol/L.Analysis of the relationship between different RC levels and acute ischemic stroke risk found that the risk of acute ischemic stroke in RC Q4(≥0.92 mmol/L)was 4.334 times that of RC Q1(≤0.51 mmol/L).Conclusion Remnant cholesterol is an independent risk factor for acute ischemic stroke,acting independently of LDL-C.Higher levels of remnant cholesterol are associated with an increased risk of acute is-chemic stroke.
关键词
急性脑梗死/残余胆固醇/残余胆固醇与低密度脂蛋白胆固醇不一致性/动脉粥样硬化/残余风险Key words
Acute ischemic stroke/Remnant cholesterol/Inconsistency between remnant choles-terol and low-density lipoprotein cholesterol/Atherosclerosis/Remnant risk引用本文复制引用
基金项目
河北省2018年政府资助专科能力建设和专科带头人项目(冀财社[2018]29)
出版年
2024
国家科技期刊平台
NSTL
万方数据