急性缺血性脑卒中复发危险因素分析及低密度脂蛋白 - 国家心血管病中心.pdf

694 中国循环杂志 2014 年 9 月 第 29 卷 第 9 期（总第 195 期）Chinese Circulation Journal，September，2014，Vol. 29 No.9（Serial No.195） 临床研究 急性缺血性脑卒中复发危险因素分析及低密度脂蛋白 与高密度脂蛋白比值对脑卒中复发的预测价值 李琦，钟纯正 摘要 目的：探讨急性缺血性脑卒中复发危险因素，并分析低密度脂蛋白（LDL）/ 高密度脂蛋白（HDL）的预测价值。 方法：对我院收治的 143 例急性缺血性脑卒中患者进行为期 2 年的随访，探讨患者复发的危险因素以及 LDL/ HDL 与脑卒中复发的相关性，分析 LDL/HDL 在脑卒中复发中的预测价值。 结果：单因素分析显示，腔隙性脑梗死、有无合并高血压、血压、LDL、HDL、LDL/ HDL、甘油三酯（TG）水平， 以及脑卒中量表评分和生活能力评分是导致缺血性脑卒中复发的危险因素；多因素分析显示合并高血压、LDL/HDL、 TG 水平是导致缺血性脑卒中复发的独立危险因素。LDL、LDL/HDL 与脑卒中复发呈明显正相关关系，HDL 水平与脑 卒中复发呈负相关（P 0.05）；LDL/HDL 检测对脑卒中复发的特异性和敏感性分别为 81.16% 和 95.65%，均显著高于两 种指标单独检测。 结论：LDL/HDL 预测缺血性脑卒中复发的作用有利于我们识别缺血性脑卒中复发的高危患者，有利于临床进行早 期的干预和预防。 关键词 急性缺血性脑卒中；复发；危险因素；预测价值 Analysis for Risk Factors and Predictive Value of LDL/HDL Ratio in Acute Ischemic Stroke Recurrence Li Qi, ZHONG Chun-zheng. Department of Neurology, The Farm’s Nada Hospital, Danzhou (571700), Hainan, China Corresponding Author: Li Qi, Email: 359337332@ Abstract Objective: To analyze the risk factors and the predictive value of LDL/HDL ratio in acute ischemic stroke recurrence. Methods: A total of 143 patients with acute ischemic stroke treated in our hospital were studied. The patients were followed-up for 2 years, the risk factors and the predictive value of LDL/HDL ratio for stroke recurrence were analyzed. Results: Single factor analysis indicated that lacunar infarction, hypertension, blood pressure, the levels of LDL, HDL, ratio of LDL/HDL, stroke scale score, life ability score were the risk factors of ischemic stroke recurrence. Multivariate analysis presented that hypertension, ratio of LDL/HDL, TG level were the independent risk factors for ischemic stroke recurrence. LDL and ratio of LDL/HDL were positively related to ischemic stroke recurrence, HDL was negati