中性粒细胞和高密度脂蛋白胆固醇及脂蛋白(a)与老年心房颤动患者合并脑卒中的相关性

Correlation of neutrophil,high-density lipoprotein cholesterol and lipoprotein(a)with stroke in elderly patients with AF

目的探讨中性粒细胞/高密度脂蛋白胆固醇比值(NHR)及脂蛋白(a)[Lp(a)]与老年非瓣膜性心房颤动(NVAF)患者合并急性缺血性脑卒中(AIS)的相关性。方法选择2020年5月至2023年5月就诊合肥市第一人民医院的老年NVAF患者301例,根据是否合并AIS分为卒中组143例和非卒中组158例,采用二元logistic回归筛选危险因素,用ROC曲线评估预测价值。结果卒中组患者Lp(a)、NHR显著高于非卒中组,差异有统计学意义(P<0.01)。多因素二元logistic回归分析显示,NHR、Lp(a)是NVAF合并AIS发生的危险因素(OR=1.728,95%CI:1.367~2.186,P=0.000;OR=1.005,95%CI:1.002~1.007,P=0.000);ROC曲线分析结果显示,NHR、Lp(a)分别诊断NVAF合并AIS的ROC曲线下面积(AUC)为0.668、0.735;NHR与Lp(a)联合诊断时,AUC为0.789,显著高于NHR和Lp(a)单独诊断(P<0.01)。结论NHR和Lp(a)与NVAF合并AIS独立相关,且两者联合对其有一定诊断效能。

Objective To investigate the correlation of neutrophil to high-density lipoprotein cholesterol ratio(NHR)and lipoprotein(a)[Lp(a)]with occurrence of acute ischemic stroke(AIS)in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 301 elderly NVAF patients admitted to Hefei First People's Hospital from May 2020 to May 2023 were enrolled,and according to whether they were combined with AIS or not,they were divided into stroke group(143 cases)and non-stroke group(158 cases).Binary logistic regression analysis was used to screen risk factors,and ROC curve was plotted to assess their predictive values for AIS.Results Lp(a)and NHR in stroke group were significantly higher than those in non-stroke group,the difference was statistically significant(P<0.01).Multivariate binary logistic regression analysis showed that NHR and Lp(a)were independent risk factors for death with NVAF combined AIS(OR=1.728,95%CI:1.367-2.186,P=0.000;OR=1.005,95%CI:1.002-1.007,P=0.000);ROC curve analysis indicated that the AUC value of NHR and Lp(a)in diagnosing AIS in NVAF patients was 0.668 and 0.735,respectively,and that of their combination was 0.789,which was significantly higher than that of NHR and Lp(a)alone(P<0.01).Conclusion NHR and Lp(a)are independently related to AIS in NVAF patients,and their combination has certain diagnostic efficacy.