血浆甘油三酯水平与缺血性卒中出院结局关系研究

摘要/Abstract

摘要：

目的探讨急性缺血性卒中患者入院时血浆甘油三酯（triglyceride，TG）水平与出院结局不良的关系。方法采用回顾性队列研究的方法，连续纳入内蒙古兴安盟人民医院2009年6月1日～2012年5月31日急性缺血性卒中患者，共计3351例。结局不良组定义为患者出院时改良Rankin量表（modified Rankin Scale，mRS）评分≥3分，对结局不良组和结局良好组患者间基线资料进行比较。用四分位数法将患者入院时血浆TG水平分为4组，用非条件Logistic回归分析入院时TG水平与急性缺血性卒中出院结局不良的关系，计算比值比（odds ratio，OR）及95%可信区间（confidence interval，CI）。结果研究对象中发生结局不良的共341例，发生率为10.2%。单因素非条件Logistic回归分析结果显示，TG相对最高分位数组（TG＞2.12?mmol/L），第1、2、3分位数组（TG分别为≤1.06?mmol/L、1.06～1.46?mmol/L、1.46～2.12?mmol/L）的结局不良发生率差异有显著性（P＜0.001）。在调整了年龄、住院天数、发病到入院时间、缺血性卒中首发、吸烟、饮酒、心脏病史、心房颤动史、高血压、高血糖和心率后，相对于最高分位数组，第3分位数组的结局不良发生率差异无显著性（P=0.0758），而第1、2分位数组结局不良发生率升高（均P＜0.0001），其OR（95%CI）分别为11.883（1.307～2.714）和2.063（1.436～2.963）。结论急性缺血性卒中患者入院时低水平TG可能独立地增加出院结局不良的风险。

文章导读： 通过较大样本量回顾性研究显示急性缺血性卒中患者入院时低甘油三酯水平与出院结局不良相关。

关键词: 急性; 缺血性卒中; 甘油三酯; 出院; 结局不良

Abstract:

Objective To assess the relationship between admission triglyceride levels and discharged poor outcome in patients with acute ischemic stroke. Methods We performed a retrospective cohort study of 3351 patients with acute ischemic stroke, who came from the People's Hospital of Inner Mongolia Xinganmeng from June 1, 2009 to May 31, 2012. Poor outcome was defined as discharged modified Rankin Scale (mRS) score??3. Compare the baseline data between poor outcome group and good outcome group. Triglyceride at admission was divided into 4 levels using the quartile method. Non-conditional Logistic regression analysis was used to assess the relationship between admission triglyceride levels and discharged poor outcome in patients with acute ischemic stroke, by calculating the odds ratio (OR) and 95% confidence interval (CI). Results A total of 341 people in the study of poor outcomes, the incidence was 10.2%. Univariate non-conditional Logistic regression analysis showed that the incidence of poor outcomes in the 1, 2, 3 percentile group (TG was??1.06?mmol/L, 1.06~1.46?mmol/L, 1.46~2.12?mmol/L) was significantly different with the highest relative percentile group (TG>2.12?mmol/L) (P<0.05). After adjusting for age, length of hospital stay, time of onset to hospitalization, first ischemic stroke, smoking, drinking, history of heart disease, fibrillation, hypertension, hyperglycemia, heart rate and triglyceride levels, compared with the highest relative percentile group, the incidence of poor outcomes in the 3 percentile group was not significantly different (P=0.0758), while the incidence of poor outcomes in the 1, 2 quartile group was significantly different (P<0.0001), the values of OR (95%CI) were 1.883(1.307~2.714) and 2.063(1.436~2.963). Conclusion Lower triglyceride levels at admission may independently increase the risk of discharged poor outcomes in patients with acute ischemic stroke.

Key words: Acute, Ischemic stroke; Triglycerides; Discharge; Poor outcome

黄萍1，李志杰2，吕利英2，马龙2，杨丽荣2，国钰梅2，白文婷2，包成月2，佟伟军1. 血浆甘油三酯水平与缺血性卒中出院结局关系研究[J]. 中国卒中杂志, 2015, 10(03): 218-224.

HUANG Ping*, LI Zhi-Jie, LV Li-Ying, MA Long, YANG Li-Rong, GUO Yu-Mei, BAI Wen-Ting, BAO Cheng-Yue, TONG Wei-Jun. . Relationship between the Triglyceride Levels and the Outcome of Ischemic Stroke [J]. Chinese Journal of Stroke, 2015, 10(03): 218-224.

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