Hutanu Adina, Iancu Mihaela, Dobreanu Minodora, Oprea Oana Roxana, Barbu Stefan, Maier Smaranda, Tero-Vescan Amelia, Bajko Zoltan, Balasa Rodica
CCAMF, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
3 Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu-Ha-tieganu", Cluj-Napoca, Romania.
Arch Med Sci. 2019 Oct 23;17(4):864-873. doi: 10.5114/aoms.2019.89302. eCollection 2021.
Our aim was to evaluate the extended lipid profile in ischemic stroke patients and the relationship with stroke type, severity and outcome.
We prospectively enrolled 124 ischemic stroke patients and 40 healthy controls; baseline plasma and erythrocyte membrane fatty acids concentrations and common lipid profile were analysed. Stroke severity was evaluated by NIHSS on admission, while the functional outcome was defined by mRS at discharge and after 3 months.
Total cholesterol, triglycerides, HDL-cholesterol, DHA, adrenic, stearic and lauric acid were all lower in patients, taking into account that 87.7% of patients did not receive statins before admission. There was a different pattern in plasma and erythrocyte membrane of fatty acids between patients and controls, also omega-3 index was significantly lower in patients. Patients with poor outcome without statins had significantly lower triglyceride ( = 0.028), while the total cholesterol levels were significantly lower in patients with poor outcome ( = 0.03) but with treatment initiated after admission. Bivariate analysis revealed that patients with poor outcome had significantly lower triglyceride levels regardless the statins use, while the total cholesterol and HDL-cholesterol levels were significantly lower in patients with poor outcome under statin treatment. The long-term outcome were positively influenced by age (β̂ = 0.22, = 0.001), and NIHSS score at admission (β̂ = 0.55, < 0.001), and negatively by cholesterol levels (β̂ = -0.17, = 0.031).
DHA, adrenic, stearic and lauric acid were lower in stroke patients; plasma adrenic acid was consumed during the acute phase. The most important predictors for long-term outcome was NIHSS at admission followed by age and total cholesterol.
我们的目的是评估缺血性中风患者的扩展血脂谱及其与中风类型、严重程度和预后的关系。
我们前瞻性纳入了124例缺血性中风患者和40例健康对照者；分析了基线血浆和红细胞膜脂肪酸浓度以及常规血脂谱。入院时通过美国国立卫生研究院卒中量表（NIHSS）评估中风严重程度，出院时和3个月后通过改良Rankin量表（mRS）定义功能预后。
考虑到87.7%的患者在入院前未接受他汀类药物治疗，患者的总胆固醇、甘油三酯、高密度脂蛋白胆固醇、二十二碳六烯酸（DHA）、肾上腺酸、硬脂酸和月桂酸均较低。患者与对照者的血浆和红细胞膜脂肪酸模式不同，患者的ω-3指数也显著较低。未使用他汀类药物且预后不良的患者甘油三酯显著较低（P = 0.028），而预后不良但入院后开始治疗的患者总胆固醇水平显著较低（P = 0.03）。双变量分析显示，无论是否使用他汀类药物，预后不良的患者甘油三酯水平均显著较低，而在他汀类药物治疗下预后不良的患者总胆固醇和高密度脂蛋白胆固醇水平显著较低。年龄（β̂ = 0.22，P = 0.001）、入院时的NIHSS评分（β̂ = 0.55，P < 0.001）对长期预后有积极影响，胆固醇水平（β̂ = -0.17，P = 0.031）对长期预后有消极影响。
中风患者的DHA、肾上腺酸、硬脂酸和月桂酸较低；急性期血浆肾上腺酸被消耗。长期预后的最重要预测因素是入院时的NIHSS评分，其次是年龄和总胆固醇。
