总胆固醇水平与急性前循环缺血性卒中血管内治疗预后的相关性分析

The correlation between the level of total cholesterol and the prognosis of intravascular therapy in patients with acute anterior circulation ischemic stroke

目的探讨总胆固醇(TC)水平与急性前循环缺血性脑卒中血管内治疗(EVT)患者预后的相关性.方法回顾性分析2017年12月至2018年12月行血管内治疗的急性前循环缺血性卒中患者91例,收集患者血管内治疗前实验室资料、美国国立卫生研究院卒中量表(NIHSS)评分等临床资料.功能结局采用90d时改良Rankin量表(mRS)评分进行评价,mRS评分0~2分为预后良好,3~6分为预后不良.根据预后将患者分为预后良好组和预后不良组.单因素分析比较两组基线资料和临床资料,多因素Logistic回归分析总胆固醇水平对预后结局的影响.结果预后良好组与预后不良组在年龄、性别、糖尿病比例、高血压病比例、心房颤动比例、冠心病比例、基线血糖、基线血压、静脉溶栓比例、脑卒中病因、闭塞部位、改良脑梗死溶栓分级(mTICI)2b/3比例比较差异无统计学意义(P>0.05),基线ASPECTS评分、基线NIHSS评分、基线胆固醇水平、基线甘油三酯水平,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,总胆固醇水平(OR=1.892,95%CI:1.059~3.381,P=0.031)、ASPECTS评分(OR=0.734,95%CI:0.626~0.882,P=0.047)分别是血管内治疗预后的保护因素和危险因素.结论血清总胆固醇水平能预测急性前循环大血管闭塞型卒中血管内治疗90d功能预后,是缺血性卒中血管内治疗的保护因素.

Objective To explore the correlation between the level of total cholesterol(TC)and clinical outcome of anterior circulation acute ischemic stroke after endovascular treatment(FVT).Methods A total of 91 patients treated with EVT in Zhejiang Provincial People's Hospital from December 2017 to December 2018 were enrolled in this study.The laboratory date before EVT such as NIHSS score.The functional outcome was evaluated by the modified Rankin Scale at 90 days.Poor functional outcome was defined as mRS of 3-6 at 90 days,while good of 0-2.According to the prognosis,the patients were divided into good prognosis group and had prognosis group.Univariate analysis was performed on baseline variables,clinical variables ami recanalization outcomes between two groups,statistically significant variables were included in the multivariate logistic regre ssion model to analyze the predictive value of the level of total cholesterol for 90-day clinical outcome.Results There was no significant difference in age,sex,diabetes,hypertension,atrial fibrillation,coronary heart disease,blood glucose,blood pressure,thrombolysis,cause of stroke,occlusive site,mTICI 2b/3 between two groups(P>0.05).There were significant differences in the aspects score,NIHSS score,cholesterol and triglyceride(P<0.05).Multivariate logistic regression analysis showed that the baseline total cholesterol level(OR=1.892,95%CI:1.059—3.381,P=0.03l)was the protective factors for good prognosis after EVT and the aspects score(OR=0.734,95%Cl:0.626-0.882,P=0047)was the risk factor.Conclusions The level of total cholesterol can predict the 90-day clinical outcome after EVT in patients with anterior circulation acute ischemic,and it is the protective factor of EVT in patients with ischemic stroke.