Xie Yun-Yan, Liu Shi-Meng, Zhang Qian, Jia Yu, Ding Jian-Ping
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, University of California, Irvine, Irvine, California, USA.
J Geriatr Cardiol. 2021 Mar 28;18(3):204-209. doi: 10.11909/j.issn.1671-5411.2021.03.011.
To investigate the associations between the blood concentrations of low-density lipoprotein cholesterol (LDL-C) and the clinical features of haemorrhagic stroke.
This study analysed the data from patients with acute haemorrhagic stroke at a comprehensive stroke centre from 2013 to 2018. Patients were stratified into three groups according to their baseline LDL-C levels: < 70, 70 to < 100 and ≥ 100 mg/dL. We used multivariate logistic regression models to analyse the associations between LDL-C and the risks of having severe neurological deficits (National Institute Health Stroke Scale [NIHSS] scores ≥ 15) and unfavourable outcomes (modified Rankin Scale [mRS] scores>2) at discharge.
Six-hundred and six patients were analysed. Their median age was 58 years. Among the patients, 75 (12%) patients had LDL-C levels < 70 mg/dL, 194 (32%) patients had LDL-C levels between 70 to < 100 mg/dL and the other 337 (56%) patients had LDL-C levels ≥ 100 mg/dL. Patients with higher LDL-C levels were less likely to suffer severe neurological deficits (LDL-C: 70 to < 100 . < 70 mg/dL, adjusted odds ratio [OR]: 0.29, 95% CI: 0.15-0.57; LDL-C: ≥ 100 . < 70 mg/dL, adjusted OR = 0.27, 95% CI: 0.15-0.51) and to have unfavourable outcomes at discharge (LDL-C: 70 to < 100 . < 70 mg/dL, adjusted OR = 0.50, 95% CI: 0.29-0.87 and LDL-C: ≥ 100 . < 70 mg/dL, adjusted OR = 0.46, 95% CI: 0.28-0.78).
An LDL-C level < 70 mg/dL was independently associated with severe neurological deficits of haemorrhagic stroke and may increase the risks of unfavourable outcomes at discharge.
探讨低密度脂蛋白胆固醇(LDL-C)血药浓度与出血性中风临床特征之间的关联。
本研究分析了2013年至2018年在一家综合中风中心的急性出血性中风患者的数据。根据患者的基线LDL-C水平将其分为三组:<70、70至<100以及≥100mg/dL。我们使用多因素逻辑回归模型分析LDL-C与出院时出现严重神经功能缺损(美国国立卫生研究院卒中量表[NIHSS]评分≥15)和不良预后(改良Rankin量表[mRS]评分>2)风险之间的关联。
共分析了606例患者。他们的中位年龄为58岁。在这些患者中,75例(12%)患者的LDL-C水平<70mg/dL,194例(3%)患者的LDL-C水平在70至<100mg/dL之间,另外337例(56%)患者的LDL-C水平≥100mg/dL。LDL-C水平较高的患者出现严重神经功能缺损的可能性较小(LDL-C:70至<100.<70mg/dL,调整后的比值比[OR]:0.29,95%置信区间[CI]:0.15 - 0.57;LDL-C:≥100.<70mg/dL,调整后的OR = 0.27,95%CI:0.15 - 0.51),且出院时出现不良预后的可能性较小(LDL-C:70至<100.<70mg/dL,调整后的OR = 0.50,95%CI:0.29 - 0.87;LDL-C:≥100.<70mg/dL,调整后的OR = 0.46,95%CI:0.28 - 0.78)。
LDL-C水平<70mg/dL与出血性中风的严重神经功能缺损独立相关,且可能增加出院时出现不良预后的风险。