目的 研究血清雌二醇(estradiol,E2)血脂与绝经后缺血性脑卒中(ischemic stroke,IS)临床病理特征的相关性及临床价值.方法 选择2019年1月至2020年1月诊治的90例绝经后IS患者(ICS组)和正常健康人(对照组)为研究对象,比较两组研究对象血清E2、血脂、美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、改良 Barthel 指数量表(modified Barthel index,MBI)及 Fug-Meyer 运动功能评定量表(Fugl-Meyer assessment scale,FMA)评分、S100 钙结合蛋白 B(S100 calcium binding protein B,S100B)、髓磷脂碱性蛋白(myelin basic protein,MBP)及Tau蛋白差异,Pearson相关性分析血清E2、血脂与NIHSS评分、MBI评分、FMA评分、S100B、MBP、Tau蛋白相关性采用受试者工作特征曲线分析检测指标预测绝经后IS患者1年死亡的效能.Logistic回归分析经后IS患者1年死亡的危险因素.结果 ICS组研究对象血清E2、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、MBI评分、Tau蛋白FMA评分均显著低于对照组组,总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、NIHSS评分、S100B及MBP均显著高于对照组,差异均有统计学意义(均P＜0.05).绝经后IS患者E2、HDL与NIHSS评分、S100B、MBP呈负相关(P＜0.05),与MBI评分、FMA评分、Tau蛋白呈正相关(P＜0.05).TC、TG、LDL与NIHSS评分、S100B、MBP呈正相关(P＜0.05),与MBI评分、FMA评分、Tau蛋白呈负相关(P＜0.05).E2预测绝经后脑卒中1年死亡截断值为31.2pg/ml,敏感度为71.9％,特异性为87.8％.TC预测绝经后脑卒中1年死亡截断值为7.3mmol/L,敏感度为61.0％,特异性为83.7％.TG预测绝经后脑卒中1年死亡截断值为2.4mmol/L,敏感度为61.2％,特异性为89.8％.LDL预测绝经后脑卒中1年死亡截断值为4.7mmol/L,敏感度为63.3％,特异性为83.7％.HDL预测绝经后脑卒中1年死亡截断值为0.5mmol/L,敏感度为72.2％,特异性为 85.5％.E2≤31.2pg/ml、TC＞7.3mmol/L、TG＞2.4mmol/L、LDL＞4.7mmol/L、HDL≤0.5mmol/L 为绝经后 IS 患者1年死亡的危险因素(P＜0.05).结论 绝经后IS患者血清E2和 HDL-C降低,TC、TG和LDL-C升高,与神经功能损伤及1年死亡事件密切相关,在预测绝经后IS1年死亡中具有重要价值.
Correlation and clinical value of estradiol,blood lipids and clinicopathological characteristics of postmenopausal ischemic stroke
Objective To study the correlation and clinical value of serum estradiol(E2)and blood lipids with the clinicopathological characteristics of postmenopausal ischemic stroke(IS).Methods Totally 90 postmenopausal IS patients(ICS group)and normal healthy people(control group)from January 2019 to January 2020 were selected as the research subjects,and the serum E2,blood lipids,National Institutes of Health Stroke Scale(NIHSS)score,modified Barthel index(MBI)and Fug-Meyer assessment scale(FMA)score,S100 calcium binding protein B(S100B),myelin basic protein(MBP)and Tau protein were compared.Pearson correlation analysis analyzed the correlation between serum E2,blood lipids and NIHSS score,MBI score,FMA score,S100B,MBP,and Tau protein.The receiver operating characteristic curve was used to analyze the effectiveness of detection indicators in predicting 1-year mortality in postmenopausal IS patients.Logistics regression analysis of risk factors for 1-year death in postmenstrual IS patients.Results The serum E2,high-density lipoprotein cholesterol(HDL-C),MBI scores,and Tau protein FMA scores of the subjects in the ICS group were all significantly lower than those in the CON group,and total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),NIHSS scores,S100B,and MBP were all significantly higher than those in the control group,and the differences were statistically significant(All P＜0.05).E2 and high-density lipoprotein cholesterol,HDL-C in postmenopausal IS patients were negatively correlated with NIHSS score,S100B,and MBP(P＜0.05),and positively correlated with MBI score,FMA score,and Tau protein(P＜0.05).TC,TG,and LDL-C were positively correlated with NIHSS score,S100B,and MBP(P＜0.05),and negatively correlated with MBI score,FMA score,and Tau protein(P＜0.05).The cutoff value of E2 for predicting 1-year death from postmenopausal stroke is 31.2pg/ml,with a sensitivity of 71.9％and a specificity of 87.8％.The cutoff value of TC for predicting 1-year death from postmenopausal stroke is 7.3mmol/L,the sensitivity is 61.0％,and the specificity is 83.7％.The cutoff value of TG for predicting 1-year death from postmenopausal stroke is 2.4mmol/L,with a sensitivity of 61.2％and a specificity of 89.8％.The cutoff value of LDL-C for predicting 1-year death from postmenopausal stroke is 4.7mmol/L,with a sensitivity of 63.3％and a specificity of 83.7％.The cutoff value of HDL-C for predicting 1-year death from postmenopausal stroke is 0.5mmol/L,the sensitivity is 72.2％,and the specificity is 85.5％.E2≤31.2pg/ml,TC＞7.3mmol/L,TG＞2.4mmol/L,LDL-C＞4.7mmol/L,HDL-C≤0.5mmol/L are risk factors for 1-year death in postmenopausal IS patients(P＜0.05).Conclusion Serum E2 and HDL-C in postmenopausal IS patients are significantly reduced,and TC,TG and LDL-C are significantly increased,which are closely related to neurological damage and 1-year death events,and have important value in predicting 1-year death in postmenopausal IS.
Ischemic strokeEstradiolBlood lipidsMenopauseClinical value
万方数据
维普
