急性脑梗死患者低密度脂蛋白水平与红细胞刚性指数的相关性分析

Analysis of the correlation between low-density lipoprotein level and erythrocyte rigidity index in patients with acute ischemic stroke

目的:探讨急性脑梗死(AIS)患者低密度脂蛋白(LDL)水平与红细胞刚性指数的关系及其临床意义。方法:回顾性分析2018年1月至2019年6月上海交通大学医学院附属仁济医院宝山分院神经内科确诊的513例AIS患者的临床与生化资料,根据入院时血LDL水平将患者分为LDL水平正常组与偏高组,并比较两组患者间的临床、生化特征;分析LDL水平与红细胞刚性指数的相关性。结果:LDL水平正常组与偏高组患者之间性别、年龄、既往病史(高血压、糖尿病、冠心病、心房颤动等),高密度脂蛋白、游离脂肪酸、红细胞聚集指数、红细胞变形指数、红细胞分布宽度,抗血小板药、降糖药及降压药使用等指标比较,差异无统计学意义;两组间红细胞刚性指数、红细胞压积、红细胞平均体积、总胆固醇、三酰甘油、LDL、载脂蛋白A1、载脂蛋白B、载脂蛋白E、扩展残疾状况评分(EDSS)及降脂药使用等指标比较,差异有统计学意义(P<0.05);LDL水平与红细胞刚性指数正相关(r=0.121,95%CI 0.035~0.206,P=0.006)。结论:AIS患者LDL水平升高与红细胞刚性指数增加相关,提示LDL可能通过影响红细胞变形功能导致AIS。

Objective:To explore the correlation between low-density lipoprotein(LDL)level and erythrocyte rigidity index in patients with acute ischemic stroke(AIS)and its clinical significance.Methods:The clinical and biochemical data of 513 patients with AIS in the Department of Neurology,Renji Hospital Baoshan Branch Affiliated to Shanghai Jiao Tong University from January 2018 to June 2019 were retrospectively analyzed.Patients were divided into normal LDL level group and high LDL level group according to the blood LDL levels determined on admission.The clinical and biochemical characteristics between the two groups were compared.The correlation between LDL level and erythrocyte rigidity index was analyzed.Results:There was no significant difference in gender,age,previous medical history(hypertension,diabetes,coronary heart disease,atrial fibrillation),high-density lipoprotein,free fatty acid,erythrocyte aggregation index,erythrocyte deformation index,red cell distribution width,antiplatelet,hypoglycemic,and antihypertensive drugs between the normal LDL group and high LDL group.There were significant differences in erythrocyte rigidity index,RBC hematocrit,mean corpuscular volume(MCV),total cholesterol,triglyceride,LDL,apolipoprotein A1,apolipoprotein B,apolipoprotein E,expanded disability status scale(EDSS)score and lipid-lowering drugs between the two groups(P<0.05).There was a positive correlation between LDL level and erythrocyte rigidity index in patients with AIS(r=0.121,95%confidence interval 0.035-0.206,P=0.006).Conclusions:Increased LDL level is associated with increased erythrocyte stiffness in patients with AIS,which indicates that AIS might be caused by LDL through affecting erythrocyte deformability.