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目的研究表明高密度脂蛋白胆固醇(High Density Lipoprotein cholesterol,HDL-C)水平可以独立预测脑卒中的不良预后和复发,然而HDL-C水平与脑卒中亚型脑血栓的结局关系仍然不明确,本研究的目的是分析脑血栓患者HDL-C水平与全因死亡的相关性。方法我们于2000年至2001年共纳入768例脑血栓患者并平均随访4.5年,其中男性489例(63.7%),平均年龄(61.6±9.2)岁。根据患者入院时HDL-C浓度四分位值将患者分为四组,即HDL-C浓度第1分位(HDL-C≤0.72mmol/L)组(Q1组,n=182),HDL-C浓度第2分位(0.721.00mmol/L)组(Q4组,n=176)。收集患者入院时的基线资料及静脉血标本,检测血糖,甘油三酯,总胆固醇以及高密度脂蛋白胆固醇等值,终点事件定义为全因死亡。结果 768例脑血栓患者总全因死亡率为20.4%(157/768)。以Q1组为基准进行计算,Q2(16.8%,36/214)、Q3(18.9%,37/196)组患者全因死亡率低于Q1组(27.5%,50/182),差异均有统计学意义(P<0.05),但是Q4组(19.3%,34/176)患者全因死亡率与Q1组(27.5%,50/182)相比无统计学意义(P>0.05)。在调整了年龄,性别等影响预后因素后,Q2(HR=0.535,95%CI=0.343-0.835,P=0.006)、Q3(HR=0.409,95%CI=0.255-0.65,P<0.001)、Q4(HR=0.497,95%CI=0.298-0.828,P=0.007)较Q1组均对脑血栓患者全因死亡具有保护作用。结论高密度脂蛋白胆固醇水平与脑血栓患者全因死亡相关。
Objective Studies have shown that high density lipoprotein cholesterol (HDL-C) level can independently predict the adverse prognosis and recurrence of stroke, however, the relationship between HDL-C level and cerebral stroke in stroke subtype is still not clear The purpose of the study was to analyze the association of HDL-C levels with all-cause mortality in patients with cerebral thrombosis. Methods We enrolled 768 patients with cerebral thrombosis from 2000 to 2001 and followed up for an average of 4.5 years. Among them, 489 (63.7%) men and 61.6 ± 9.2 years of age were male. The patients were divided into four groups according to HDL-C quartiles: HDL-C concentration 0.72mmol / L (group Q1, n = 182), HDL- The second place of C concentration (0.72 1.00 mmol / L) group (Q4 group, n = 176). Baseline data and venous blood samples were collected at hospital admission, and blood glucose, triglycerides, total cholesterol and high-density lipoprotein cholesterol were measured. The end point was defined as all-cause death. Results The total all-cause mortality of 768 cerebral infarction patients was 20.4% (157/768). All-cause mortality was lower in Q1 (16.8%, 36/214) and Q3 (18.9%, 37/196) patients than in Q1 (27.5%, 50/182), with statistical differences (P <0.05). However, the all-cause mortality rate in Q4 group (19.3%, 34/176) was not significantly different from that in Q1 group (27.5%, 50/182) (P> 0.05). After adjustment for age, sex and other prognostic factors, Q (HR = 0.409, 95% CI = 0.255-0.65, P <0.001) Q4 (HR = 0.497, 95% CI = 0.298-0.828, P = 0.007) had a protective effect on all-cause death in patients with cerebral thrombosis compared with those in the control group. Conclusions High-density lipoprotein cholesterol levels are associated with all-cause mortality in patients with cerebral thrombosis.