Correlation between blood lipid level at hospital admission and adverse outcome after hospitalization among acute ischemic stroke patients
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摘要: 目的 探讨急性缺血性卒中患者入院血脂水平及其出院后不良结局的关系,为急性缺血性卒中的治疗及二级预防提供科学依据。方法 采用回顾性队列研究方法于2015年1月1日—2015年8月31日在中国医科大学附属第一医院鞍山医院、丹东市第一医院、辽阳县医院和大洼县医院收集1 614例入院治疗、出院第一诊断为急性缺血性卒中的患者,分析其血脂水平及其与出院后不良结局的关系。结果 1 614例急性缺血性卒中患者的高总胆固醇(TC)、高甘油三酯(TG)和高低密度脂蛋白胆固醇(LDL-C)率分别为37.7%、36.9%和31.0%,低高密度脂蛋白胆固醇(HDL-C)率为19.0%;急性缺血性卒中患者改良Rankin量表(mRS)得分为(1.46±1.79)分,出院不良结局比例为23.3%;在控制了性别、年龄、吸烟、饮酒、高血压病史、糖尿病病史等混杂因素后,多因素非条件logistic回归分析结果显示,TG为1.00~1.39 mmol/L和LDL-C为2.95~3.53 mmol/L对急性缺血性卒中患者出院后短期不良结局具有一定保护作用。结论 急性缺血性卒中患者入院时较高TG和LDL-C水平可以减少短期不良结局的发生。Abstract: Objective To investigate the relationship between blood lipid level at hospital admission and adverse outcome after hospitalization in acute ischemic stroke (AIS) patients and to provide evidences for secondary prevention of AIS.Methods We conducted a retrospective cohort study in four general hospitals (two at municipal level in Anshan and Dandong city and two at county level in Liaoyang and Dawa county of Liaoning province).We extracted medical records of 1 641 patients hospitalized between January 1st and August 31st,2015 and diagnosed primarily as AIS at hospital discharge and carried up a follow-up survey to collect information on AIS-related outcome.Results Of all the AIS patients,37.7%,36.9%,and 31.0% showed high levels of total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C) and 19.0% showed a low level of high density lipoprotein cholesterol (HDL-C),respectively,at the first test after hospitalization.The score of modified Rankin Scale (mRS) was 1.46±1.79 and the proportion of with adverse outcome after hospitalization discharge was 23.3% for all the AIS patients.The results of unconditional multivariate logistic regression analysis revealed that TG level of 1.00-1.39 mmol/L and LDL-C level of 2.95-3.53 mmol/L at hospital admission exerted a short-term protective effect against adverse outcome post hospitalization after adjusting for gender,age,smoking,alcohol consumption,history of hypertension,history of diabetes and other potential confounding factors.Conclusion High levels of TG and HDL-C at hospital admission may have protective effect against short-term adverse outcomes among AIS patients.
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Key words:
- ischemic stroke /
- blood lipid /
- adverse outcome /
- relationship
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