非传统脂质参数与急性轻型缺血性卒中患者院内复发的相关性

Correlation between non-traditional lipid parameters and in-hospital recurrence in patients with acute minor ischemic stroke

目的探讨非传统脂质参数与急性轻型缺血性卒中(acute minor ischemic stroke,AMIS)患者院内卒中复发的相关性。方法回顾性纳入2012年、2014年、2016年及2018年的3月、6月、9月及12月在发病72 h内入住山西省3家分中心医院的AMIS患者。收集人口统计学信息、临床特征、血脂参数以及院内卒中复发事件。非传统脂质参数包括低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)/高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)比值、总胆固醇(total cholesterol,TC)/HDL-C比值、甘油三酯(triglycerides,TG)/HDL-C比值以及非HDL-C水平。应用多变量logistic回归分析确定非传统脂质参数与院内卒中复发风险的独立相关性。结果共纳入1040例AMIS患者,男性727例(69.9%),年龄(61.5±13.0)岁;51例(4.904%)出现院内卒中复发,平均入院至复发时间(7.4±5.7)d。436例(41.9%)AMIS患者伴有颅内动脉粥样硬化性狭窄,年龄(61.0±12.5)岁,男性304例(69.7%);26例(6.0%)发生院内卒中复发,入院至复发时间(7.8±6.2)d。多变量logistic分析显示,校正混杂变量后,TC/HDL-C比值[优势比(odds ratio,OR)1.35,95%置信区间(confidence interval,CI)1.02~1.77;P=0.035]和非HDL-C(OR 1.37,95%CI 1.02~1.77;P=0.045)较高是院内卒中复发的独立危险因素。在伴颅内动脉粥样硬化性狭窄的AMIS患者中,仅非HDL-C较高与院内卒中复发风险显著独立相关(OR 1.67,95%CI 1.05~2.65;P=0.030)。结论非传统脂质参数较高与AMIS患者院内卒中复发风险增高相关。

Objective To investigate the correlation between non-traditional lipid parameters and in-hospital recurrence in patients with acute minor ischemic stroke(AMIS).Methods Patients with AMIS admitted to three sub-central hospitals in Shanxi Province within 72 h of onset in March,June,September,and December of 2012,2014,2016,and 2018 were retrospectively included.The demographic information,clinical features,blood lipid parameters,and in-hospital stroke recurrence events were collected.Non-traditional lipid parameters included low density lipoprotein cholesterol(LDL-C)/high density lipoprotein cholesterol(HDL-C)ratio,total cholesterol(TC)/HDL-C ratio,triglycerides(TG)/HDL-C ratio,and non-HDL-C levels.Multivariate logistic regression analysis was used to determine the independent correlation between the non-traditional lipid parameters and the risk of in-hospitals stroke recurrence.Results A total of 1040 patients with AMIS were included,including 727 males(69.9%),aged 61.5±13.0 years old;51 patients(4.904%)experienced in-hospital stroke recurrence,with an average time from admission to recurrence was 7.4±5.7 d.Four hundred and thirty-six(41.9%)AMIS patients complicated with ICAS,aged 61.0±12.5 years old,with 304 males(69.7%);26(6.0%)experienced recurrence of in-hospital stroke,and the time from admission to recurrence was 7.8±6.2 d.Multivariate logistic analysis showed that after adjusting for confounding variables,the higher TC/HDL-C ratio(odds ratio[OR]1.35,95%confidence interval[CI]1.02-1.77;P=0.035)and non-HDL-C(OR 1.37,95%CI 1.02-1.77;P=0.045)were the independent risk factors for in-hospital stroke recurrence.In AMIS patients with intracranial atherosclerotic stenosis,only higher non-HDL-C was significantly and independently associated with the risk of in-hospital stroke recurrence(OR 1.67,95%CI 1.05-2.65;P=0.030).Conclusion The higher non-traditional lipid parameters are associated with an increased risk of in-hospital stroke recurrence in patients with AMIS.