sdLDL-C、Hcy、NLR与老年急性脑梗死患者颈动脉粥样硬化的相关性研究

Correlation of sdLDL-C,Hcy,NLR and Carotid Atherosclerosis in Elderly Patients with Acute Cerebral Infarction

目的:分析小而密低密度脂蛋白胆固醇(sdLDL-C)、同型半胱氨酸(Hcy)、中性粒细胞与淋巴细胞比值(NLR)与老年急性脑梗死(ACI)患者颈动脉粥样硬化的关系。方法:采用回顾性方法,收集2020年7月—2021年6月北京市老年病医院心内科收治的98例老年ACI患者作为ACI组,同期选取100例老年健康体检者作为对照组,分别对两组研究对象进行sdLDL-C、Hcy、NLR水平的检测。ACI组患者根据超声检查颈动脉内的内、中膜厚度中层厚度(IMT)值分为正常组30例、轻度狭窄组20例、中度狭窄组25例、重度狭窄组23例,比较各组间sdLDL-C、Hcy、NLR水平,分析其与IMT值相关性。绘制受试者工作ROC曲线,分析sdLDL-C、Hcy、NLR预测老年急性脑梗死患者颈动脉粥样硬化的价值。结果:ACI组sdLDL-C、Hcy、NLR水平明显高于对照组,差异有统计学意义(t=6.985、8.783、7.146,P<0.05);sdLDL-C、Hcy、NLR水平在正常组、轻度狭窄组、中度狭窄组、重度狭窄组中逐渐升高,差异有统计学意义(F=25.251、31.956、31.956,P<0.05)。sdLDL-C、Hcy、NLR水平与IMT值呈正相关。sdLDL-C、Hcy、NLR三者联合预测老年急性脑梗死患者颈动脉粥样硬化的曲线下面积(AUC)为0.867,灵敏度和特异度可达到80.8%、80.0%,优于单独一项检测的价值。结论:sdLDL-C、Hcy、NLR在老年急性脑梗死患者中明显升高,并且与急性脑梗死患者颈动脉粥样硬化呈正相关,联合检测可用于患者病情评估及判断预后。

Objective:To analyze the association of small and dense low-density lipoprotein cholesterol(sdLDL-C),homocysteine(Hcy),and neutrophil-to-lymphocyte ratio(NLR)assays with carotid atherosclerosis in elderly patients with acute cerebral infarction(ACI).Methods:Using a retrospective method,98 elderly ACI patients admitted to the hospital from July 2020 to June 2021 were collected as the ACI group,and 100 elderly health checkups were selected as the control group during the same period.The sdLDL-C,Hcy,and NLR levels were measured separately in the two study groups.The patients in the ACI group were divided into 30 cases in the normal group,20 cases in the mild stenosis group,25 cases in the moderate stenosis group,and 23 cases in the severe stenosis group according to the IMT value of the intima and media thickness in the carotid artery by ultrasound.The levels of sdLDL-C,Hcy,and NLR were compared between the groups,and their correlation with IMT values was analyzed.Subject work(ROC)curves were plotted to analyze the value of sdLDL-C,Hcy,and NLR in predicting carotid atherosclerosis in elderly patients with acute cerebral infarction.Results:The levels of sdLDL-C,Hcy,and NLR in the ACI group were significantly higher than those in the control group,and the difference was statistically significant(t=6.985,8.783,7.146,P<0.05).The sdLDL-C,Hcy,and NLR levels gradually increased in the normal,mild stenosis,moderate stenosis,and severe stenosis groups,and the differences were statistically significant(F=25.251,31.956,31.956,P<0.05).The levels of sdLDL-C,Hcy,and NLR were positively correlated with IMT values.The area under the curve(AUC)of sdLDL-C,Hcy,and NLR combined to predict carotid atherosclerosis in elderly patients with acute cerebral infarction was 0.867,and the sensitivity and specificity could reach 80.8%and 80.0%,which was better than the value of one test alone.Conclusion:sdLDL-C,Hcy,and NLR were significantly elevated in elderly patients with acute cerebral infarction and positively correlated with carotid atherosclerosis in patients with acute cerebral infarction,and the combined test can be used for patient condition assessment and prognosis determination.