Abstract: Objective To clarify the relationship between serum lipids and prognosis of acute ischemic stroke.Methods We collected data of patients with a acute brain infarction. Divide the patients into two parts. One is atherothrombosis, the other is non-atherothrombosis. Survival and dependency were assessed at 3 months. Using logistic regression model to estimate the relationship between serum lipids and prognosis.Results A total of 459 patients were included, 310 were identified as atherothrombosis. Compared to non-atherosclerosis-based stroke patients, atherosclerosis groups were older, higher triglyceride, higher cholesterol total, higher rates of diabetes mellitus and hypertension(P=0.000, 0.000, 0.001, 0.018, 0.015). On non-atherosclerotic stroke patients, HDL-C had an independent negative correlation with poor prognosis(OR 0.068, 95%CI 0.005-0.897).Conclusion HDL-C level is one of the prognosis of non-atherosclerotic stroke protective factors.

Key words: Brain infarction; Dyslipidemias; Cholesterol; HDL-C; Prognosis

摘要： 目的 探讨缺血性卒中患者急性期血清血脂水平与其短期预后之间的关系。方法 收集急性缺血性卒中患者459例，经病因学分型后分为动脉粥样硬化型卒中组（n=310）和非动脉粥样硬化型卒中组（n=149），随访患者发病后3个月的死亡、残疾情况。分析不同病因分型缺血性卒中患者预后影响因素。统计方法采用单因素分析及多元逐步Logistic回归分析。结果 与非动脉粥样硬化卒中患者相比，动脉粥样硬化型卒中患者年龄较大，既往有高血压病、糖尿病比率高，甘油三酯、总胆固醇水平较高，差异有统计学意义（P值分别为0.000，0.000，0.001，0.018，0.015）。非动脉粥样硬化患者中，高密度脂蛋白胆固醇（high density lipoprotein Cholesterol，HDL-C）水平与预后不良呈负相关，优势比（odds ratio，OR）为0.068，95%可信区间（confidence interval，CI）为（0.005～0.897）。结论 较高的HDL-C水平是非动脉粥样硬化型卒中预后良好的保护因素。

关键词: 脑梗死; 血脂异常; 胆固醇; HDL-C; 预后