Li Wei, Liu Ming, Wu Bo, Liu Hua, Wang Li-Chun, Tan Song
Department of Neurology, West China Hospital of Sichuan University, 610041, Chengdu, PR China.
Adv Ther. 2008 Apr;25(4):329-41. doi: 10.1007/s12325-008-0045-7.
The possible correlation between serum lipid levels and outcome after stroke is still controversial. Therefore we examined whether serum lipid levels at admission had any prognostic value in the 3-month outcome after stroke.
We performed a prospective, observational study of 649 patients with acute ischaemic stroke and intracerebral haemorrhagic stroke (ICH). Information on age, sex, history of arterial hypertension, diabetes mellitus, drinking, current smoking status, stroke type, Glasgow Coma Scale and Scandinavian Stroke Scale score, time from stroke onset, and presence of atrial fibrillation was obtained. Serum lipid levels were measured in blood samples taken from fasting patients 12 to 48 hours following ictus. Death and poor neurological outcome (Modified Rankin Scale score of > or =3 points) were defined as outcome events. A logistic regression model was performed to estimate the effect of the above variables on outcome after stroke.
We found that the median levels of serum total cholesterol (TC), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) in good outcome patients with acute stroke were significantly higher (P<0.005) than those of poor outcome patients. The low levels of serum TC, TG and HDL-C (P<0.05) were independently related to increased 3-month poor outcome after acute ischaemic stroke and ICH. However, there was no significant relationship between LDL-C levels and 3-month outcome.
The data from this study show that low levels of serum TC, TG and HDL-C are strong independent predictors of 3-month poor outcome in patients with acute ischaemic stroke and ICH.
血清脂质水平与卒中后预后之间的可能关联仍存在争议。因此,我们研究了入院时的血清脂质水平对卒中后3个月预后是否具有任何预测价值。
我们对649例急性缺血性卒中和脑出血(ICH)患者进行了一项前瞻性观察研究。获取了有关年龄、性别、动脉高血压病史、糖尿病、饮酒、当前吸烟状况、卒中类型、格拉斯哥昏迷量表和斯堪的纳维亚卒中量表评分、卒中发作时间以及房颤情况的信息。在发病后12至48小时从空腹患者采集的血样中测量血清脂质水平。将死亡和不良神经功能预后(改良Rankin量表评分为≥3分)定义为预后事件。进行逻辑回归模型以估计上述变量对卒中后预后的影响。
我们发现急性卒中预后良好患者的血清总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)的中位数水平显著高于预后不良患者(P<0.005)。血清TC、TG和HDL-C水平低(P<0.05)与急性缺血性卒中和ICH后3个月不良预后增加独立相关。然而,低密度脂蛋白胆固醇(LDL-C)水平与3个月预后之间无显著关系。
本研究数据表明,血清TC、TG和HDL-C水平低是急性缺血性卒中和ICH患者3个月不良预后的强有力独立预测因素。