TG、LDL-C、单核细胞与HDL-C的比值预测卵圆孔未闭患者心源性卒中的价值

The value of TG, LDL-C, monocyte/HDL-C ratio in predicting cardiogenic stroke in patients with patent foramen ovale

目的 探讨三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、单核细胞与高密度脂蛋白胆固醇(HDL-C)比值与卵圆孔未闭(PFO)患者发生心源性卒中的关系。方法 选取2020年12月—2022年6月于四川省达州市中心医院诊治的PFO患者275例临床资料,根据患者是否合并心源性卒中分为心源性卒中组(卒中组)62例和非心源性卒中组(非卒中组)213例。比较2组患者一般资料、血常规指标、TG/HDL-C、LDL-C/HDL-C、单核细胞计数(MON)/HDL-C水平。绘制受试者工作特征曲线(ROC)分析TG/HDL-C、LDL-C/HDL-C、MON/HDL-C评估PFO患者发生心源性卒中的价值。结果 卒中组合并高血压比例高于非卒中组(χ^(2)/P=7.352/0.007),2组性别、年龄、症状表现、PFO分级、吸烟史、饮酒史、合并糖尿病、合并高胆固醇、伴偏头痛、PFO家族史、治疗史比较,差异无统计学意义(P>0.05);卒中组TG/HDL-C、LDL-C/HDL-C、MON/HDL-C水平均高于非卒中组(t=7.644、7.509、7.544,P均<0.001);绘制ROC曲线结果显示,TG/HDL-C、LDL-C/HDL-C、MON/HDL-C单独及三者联合评估PFO患者心源性卒中的曲线下面积(AUC)分别为0.813、0.815、0.819、0.904,三者联合预测价值高于单项预测(Z/P=2.446/0.014、2.153/0.031、1.974/0.048)。结论 TG、LDL-C、MON与HDL-C比值升高与PFO患者心源性卒中有关,在PFO患者发生心源性卒中的预测中具有可靠性。

Objective To investigate the relationship between triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), monocyte/high-density lipoprotein cholesterol(HDL-C) ratio and cardiac stroke in patients with patent foramen ovale(PFO). Methods The clinical data of 275 patients with PFO diagnosed and treated in Dazhou Central Hospital of Sichuan Province from December 2020 to June 2022 were selected and divided into cardiogenic stroke group(stroke group) of 62 patients and non-cardiogenic stroke group(non stroke group) of 213 patients according to whether the patients were complicated with cardiogenic stroke. The general data, blood routine indexes, TG/HDL-C, LDL-C/HDL-C, and monocyte count(MON)/HDL-C were compared between the two groups. Draw the ROC of subjects to analyze the value of TG/HDL-C, LDL-C/HDL-C, MON/HDL-C in assessing the occurrence of cardiogenic stroke in PFO patients. Results The proportion of stroke group with hypertension is higher than that of non stroke group(χ^(2)/P=7.352/0.007), there was no significant difference between the two groups in gender, age, symptoms, PFO classification, smoking history, drinking history, diabetes, hypercholesterolemia, migraine, PFO family history, and treatment history(P>0.05). The levels of TG/HDL-C, LDL-C/HDL-C, MON/HDL-C in stroke group were higher than those in non stroke group(t=7.644,7.509,7.544,P<0.001). The ROC curve results showed that the area under the curve(AUC) of cardiogenic stroke in PFO patients assessed by TG/HDL-C, LDL-C/HDL-C, MON/HDL-C alone or jointly was 0.813,0.815,0.819,0.904, respectively. The combined predictive value of the three was higher than that of the single prediction(Z/P=2.446/0.014,2.153/0.031,1.974/0.048).Conclusion The increase of TG, LDL-C, MON and HDL-C ratio is related to cardiogenic stroke in PFO patients, which is reliable in predicting cardiogenic stroke in PFO patients.