血清氧化型低密度脂蛋白水平与大动脉粥样硬化性脑梗死患者中国缺血性卒中亚型分型和神经功能缺损程度的相关性研究

Correlations of Serum ox-LDL Level with Chinese Ischemic Stroke Subclassification Classification and Neurological Deficit Degree in Patients with Large-artery Atherosclerotic Cerebral Infarction

目的探讨血清氧化型低密度脂蛋白(ox-LDL)水平与大动脉粥样硬化性(LAA)脑梗死患者中国缺血性卒中亚型(CISS)分型和神经功能缺损程度的相关性。方法选取2016年6月—2017年8月河南科技大学第一附属医院收治的LAA脑梗死患者60例作为观察组,根据CISS分型分为载体动脉阻塞穿支组(A组,n=33)、动脉-动脉栓塞组(B组,n=10)、低灌注/栓子清除下降组(C组,n=11)、混合机制组(D组,n=6);另选取同期于河南科技大学第一附属医院体检健康者54例作为对照组。比较对照组与观察组受试者一般资料和实验室检查指标,并比较不同CISS分型LAA脑梗死患者血清ox-LDL水平和美国国立卫生研究院卒中量表(NIHSS)评分;血清ox-LDL水平与LAA脑梗死患者CISS分型和神经功能缺损程度的相关分析采用Spearman秩相关分析。结果对照组与观察组受试者性别、吸烟史及血清高密度脂蛋白(HDL)、总胆固醇(TC)、三酰甘油(TG)水平比较,差异无统计学意义(P>0.05);观察组患者年龄大于对照组,血清低密度脂蛋白(LDL)、ox-LDL水平高于对照组(P<0.05)。A组、B组、C组患者血清ox-LDL水平低于D组(P<0.05);A组、C组患者血清ox-LDL水平低于B组(P<0.05)。A组、B组、C组患者NIHSS评分低于D组(P<0.05);A组患者NIHSS评分低于C组(P<0.05)。Spearman秩相关分析结果显示,血清ox-LDL水平与LAA脑梗死患者CISS分型无直线相关关系(rs=0.252,P>0.05);血清ox-LDL水平与LAA脑梗死患者神经功能缺损程度呈正相关(rs=0.269,P<0.05)。结论血清ox-LDL水平与LAA脑梗死患者CISS分型无直线相关关系,但与神经功能缺损程度呈正相关。

Objective To investigate the correlations of serum ox-LDL level with Chinese Ischemic Stroke Subclassification（CISS） classification and neurological deficit degree in patients with large-artery atherosclerotic cerebral infarction. Methods A total of 60 patients with large-artery atherosclerotic cerebral infarction were selected as observation group in the First Affiliated Hospital of Henan University of Science and Technology from June 2016 to August 2017, and they were divided into A group（with perforating branch obstructed by carrier artery, n=33）, B group（with arterial-arterial embolism, n=10）, C group（with poor perfusion or embolus removal ability, n=11） and D group（with mixed mechanism, n=6） according to CISS classification; meanwhile 54 healthy volunteers were selected as control group. General information and laboratory examination results were compared between control group and observation group, serum ox-LDL level and NIHSS score were compared in A group, B group, C group and D group; Spearman rank correlation analysis was used to analyze the correlations of serum ox-LDL level with CISS classification and neurological deficit degree in patients with large-artery atherosclerotic cerebral infarction. Results No statistically significant differences of gender, smoking history, serum level of HDL, TC or TG was found between control group and observation group（P〉0.05）; age in observation group was statistically significantly older than that in control group, serum levels of LDL and ox-LDL in observation group were statistically significantly higher than those in control group（P〈0.05）. Serum ox-LDL level in A group, B group and C group was statistically significantly lower than that in D group, respectively, meanwhile serum ox-LDL level in A group and C group was statistically significantly lower than that in B group, respectively（P〈0.05）. NIHSS score in A group, B group and C group was statistically significantly lower than that in D group, respectively（P〈0.05）, meanwhile NIHSS score in A group was statistically significantly lower than that in C group（P〈0.05）. Spearman rank correlation analysis results showed that, serum ox-LDL level was not linearly correlated with CISS classification in patients with large-artery atherosclerotic cerebral infarction（rs=0.252, P〉0.05）, while it was positively correlated with neurological deficit degree（rs=0.269, P〈0.05）. Conclusion Serum ox-LDL level is not linearly correlated with CISS classification in patients with large-artery atherosclerotic cerebral infarction, while it is positively correlated with neurological deficit degree.