颅内段动脉粥样硬化性狭窄患者残余胆固醇及脂质比水平分析

Analysis of residual cholesterol and lipid ratio in patients with intracranial atherosclerotic stenosis

目的探讨残余胆固醇(RC)及血脂比值与颅内动脉粥样硬化性狭窄(ICAS)的相关性及其预测价值。方法回顾性分析2018—2021年呼伦贝尔市人民医院神经内科住院及门诊就诊患者的临床资料,经颅脑CT血管成像(CTA)检查,选取ICAS患者144例作为病例组,以同期121例无ICAS患者为对照组。应用残余胆固醇=总胆固醇-(低密度脂蛋白胆固醇+高密度脂蛋白胆固醇)来计算RC。利用二元Logistic回归分析、Spearman相关分析、ROC曲线分析RC、血脂比值及单纯血脂指标与ICAS发生及狭窄程度的关系。结果病例组总胆固醇(TC)、RC、非高密度脂蛋白胆固醇(non-HDL-C)、TC/HDL-C、non-HDL-C/HDL-C水平明显高于对照组(P<0.01)。TC、低密度脂蛋白胆固醇(LDL-C)、RC、TC/HDL-C与ICAS的狭窄程度呈显著正相关(P<0.01)。RC、TC/HDL-C、非HDL-C/HDL-C的受试者操作特征曲线下面积(AUC)均高于LDL-C。结论RC、TC/HDL-C与ICAS的发生密切相关,且较LDL-C具有更高的预测价值。

Objective To investigate the correlation between residual cholesterol(RC)and lipid ratio and intracranial atherosclerotic stenosis(ICAS)and their predictive value.Methods the clinical data of inpatients and outpatients in the Department of Neurology of Hulun Buir People’s Hospital from 2018 to 2021 were retro⁃spectively analyzed.After brain CT angiography(CTA),144 patients with ICAS were selected as the case group,and 121 patients without ICAS were selected as the control group.RC was calculated using RC=TC-(LDL-C+HDL-C).Binary logistic regression analysis,Spearman correlation analysis and ROC curve analysis were used to explore the relationship between RC,blood lipid ratio and simple blood lipid index and the occurrence and steno⁃sis of ICAS.Results The levels of total cholesterol(TC),RC,non-high-density lipoprotein cholesterol(non-HDL-C),TC/HDL-C,non-HDL-C/HDL-C in the case group were significantly higher than those in the con⁃trol group(P<0.01).TC,low density lipoprotein cholesterol(LDL-C),RC,TC/HDL-C were positively correlated with the stenosis of ICAS(P<0.01).The area under operating characteristic curve(AUC)of RC,TC/HDL-C and non-HDL-C/HDL-C subjects were higher than that of LDL-C.Conclusion RC,TC/HDL-C are closely relat⁃ed to the occurrence of ICAS,and have better predictive value than LDL-C.