HCY HDL-C比值与急性缺血性脑卒中的关联性分析

目的探讨急性缺血性脑卒中(AIS)患者同型半胱氨酸、高密度脂蛋白胆固醇及其比值的临床价值。方法回顾性分析浙江省中医院2021年3月至2020年2月AIS确诊患者56例(AIS组),同期健康体检者102例(对照组)的血生化指标,首先评估观察对象的组间可比性,其次计算同型半胱氨酸、高密度脂蛋白胆固醇比值(同高比值),单因素分析血生化指标及同高比值在两组之间的差异性,最后多因素logistic回归分析血生化指标以及同高比值的临床价值。结果两组观察对象具有可比性,两组观察对象的甘油三酯、低密度脂蛋白胆固醇差异无统计学意义(P>0.05);AIS组高血压患病率和空腹血糖明显高于对照组(P<0.01),总胆固醇和高密度脂蛋白胆固醇明显低于对照组(P<0.01),血清同型半胱氨酸水平高于对照组(P<0.05),AIS组同高比值则明显高于对照组(P<0.01);回归分析显示总胆固醇和同型半胱氨酸差异无统计学意义(P>0.05),葡萄糖、高密度脂蛋白胆固醇和同高比值差异具有统计学意义(P<0.05),其中葡萄糖OR值1.515、同高比值OR值1.216,高密度脂蛋白胆固醇OR值0.022。结论同型半胱氨酸和总胆固醇与AIS相关联,但其并非AIS的独立危险因素,葡萄糖、高密度脂蛋白胆固醇和同高比值不仅与AIS相关联而且还是疾病的独立危险因素,同高比值有利于提升同型半胱氨酸在AIS的临床价值。

Objective To explore the clinical significance of homocysteine,high density lipoprotein cholesterol and their ratio in patients with acute ischemic stroke(AIS).Methods From March 2021 to February 2022,a total of 56 patients with acute ischemic stroke admitted to the Department of Neurology,Zhejiang Provincial Hospital of Chinese Medicine and 102 healthy check-ups without acute stroke in the same period were retrospectively analyzed.Firstly the comparability between the groups was evaluated,and then homocysteine to high density lipoprotein cholesterol ratio was calculated,the clinical value of several blood indicators and the ratio between the two groups were analyzed.Results The two groups were comparable.There was no significant difference in triglyceride and low density lipoprotein cholesterol between the two groups(P>0.05).The hypertension and fasting blood glucose in AIS group were significantly higher than those in the control group(P<0.01).The levels of total cholesterol and high-density lipoprotein cholesterol in AIS group were significantly lower than those in the control group(P<0.01),while the levels of homocysteine were higher than those in the control group.Moreover,the ratio in AIS group was significantly higher than that in the control group.The logistic regression analysis showed that total cholesterol and homocysteine were not statistically significant,but glucose,high-density lipoprotein cholesterol and the ratio were statistically significant,in which glucose OR value was 1.515,the ratio OR value was 1.216,and high-density lipoprotein cholesterol OR value was 0.022.Conclusion Homocysteine and total cholesterol are associated with AIS,but they are not independent risk factors for AIS.Glucose,high-density lipoprotein cholesterol and homocysteine to high density lipoprotein cholesterol ratio are not only associated with acute ischemic stroke but also independent risk factors for the disease.Homocysteine to high density lipoprotein cholesterol ratio is conducive to improving the clinical value of homocysteine in acute ischemic stroke.