急性脑卒中患者血清前清蛋白、血脂、血清脂蛋白与预后的关系

Relationship between serum prealbumin,blood lipid and serum lipoprotein with prognosis in patients with acute stroke

目的探讨血清前清蛋白、血脂和血清脂蛋白谱检测对急性脑卒中患者的临床价值。方法选取2013年3月至2015年12月上海市宝山区大场医院收治的100例急性脑卒中患者,根据脑卒中类型不同分为脑出血组(57例)和脑梗死组(43例),另选取同期在上海市宝山区大场医院进行健康体检者100例作为对照组。比较受试者血清前清蛋白、血脂、血清脂蛋白谱水平,并采用Cox回归分析探讨脑卒中患者临床预后的风险因素。结果脑梗死组及脑出血组血清前清蛋白、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较对照组高,高密度脂蛋白胆固醇(HDL-C)水平较对照组低,脑梗死组TC、LDL-C水平较脑出血组高,差异均有统计学意义(P<0.05);血清前清蛋白、α脂蛋白(αLP)、β脂蛋白(βLP)、前β脂蛋白(preβLP)是脑卒中患者预后不良的独立风险因素(P<0.05)。结论血清前清蛋白、血清脂蛋白谱是急性脑卒中患者死亡的独立危险因素,值得临床关注。

Objective To investigate the clinical application value of serum prealbumin,blood lipid and serum lipoprotein spectrum detection in the patients with acute stroke.Methods One hundred patients with acute cerebral stroke in the Baoshan District Dayang Hospital from March 2013 to December 2015 were selected and divided into the cerebral hemorrhage group(57 cases) and cerebral infarction group(43 cases) according to the stroke type,and contemporaneous 100 individuls undergoing physical examination served as the control group.The levels pf serum prealbumin,blood lipid and serum lipoprotein spectrum were compared among the subjects.The Cox regression analysis was adopted to analyze the risk factors of clinical prog-nosis in the patients with stroke.Results The levels of serum prealbumin,total cholesterol(TC),triacylglycerol(TG) and low density lipoprotein cholesterol(LDL-C) in the cerebral infarction group and cerebral hemorrhage group were higher than those in the control group,while the high density lipoprotein cholesterol(HDL-C) level was lower than that in the control group,the levels of TC and LDL-C in the cerebral infarction group were higher than those in the cerebral hemorrhage group,the difference were statistically significant(P <0.05);serum prealbumin,α lipoprotein(αLP),βlipoprotein(βLP) and preβLP were the independent risk factors of poor adverse in the patients with stroke(P<0.05).Conclusion Serum prealbumin and lipoprotein spectrum are the death in the patients with stroke and deserves the clinical attention.