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入院前低密度脂蛋白胆固醇浓度与大型脑出血风险的关系:来自开滦研究的结果。

Association between preadmission low-density lipoprotein cholesterol concentration and risk of large intracerebral hemorrhage: Results from the Kailuan study.

机构信息

Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.

Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China.

出版信息

J Clin Lab Anal. 2022 Dec;36(12):e24787. doi: 10.1002/jcla.24787. Epub 2022 Nov 28.

Abstract

BACKGROUND

To examine the association between low-density lipoprotein cholesterol (LDL-C) concentrations and the risk of a large hematoma volume after intracerebral hemorrhage (ICH).

METHODS

Patients from the Kailuan study (Tangshan, China) who were hospitalized with ICH during 2006 and 2020 were included in this study. The concentration of lipid concentrations, hematoma volume and other clinical characteristics were retrospectively collected and analyzed. Hematoma volumes were measured on the first available brain scan using the ABC/2 method. LDL-C concentrations were obtained from the last physical examination before the occurrence of ICH. LDL-C concentration was categorized into four groups in accordance with the quartiles. Logistic regression was used to assess the association between LDL-C concentrations and the risk of a large hematoma volume of ≥30 ml. A generalized linear regression model was used to analyze the dose-response relationship between LDL-C concentration and hematoma volume.

RESULTS

A total of 836 patients with ICH were evaluated. In the Multivariate logistic regression, compared to the second quartile of LDL_C, the first quartile of LDL_C had a significantly higher risk of a large hematoma volume (OR 2.49 [95% CI 1.54-4.01]), and the higher quartile of LDL_C is not associated with higher odds of large hematoma volume. In the generalized linear regression model, the adjusted β for the association between LDL-C concentration and hematoma volume was 9.46 (95% confidence interval 2.87-16.04), whereas higher LDL-C concentration was not associated with a large hematoma volume.

CONCLUSIONS

This study confirmed that low LDL-C concentrations prior to ICH are associated with a higher risk of a large hematoma volume.

摘要

背景

探讨低密度脂蛋白胆固醇(LDL-C)浓度与脑出血(ICH)后血肿体积增大风险之间的关系。

方法

本研究纳入了 2006 年至 2020 年期间因 ICH 住院的开滦研究(中国唐山)患者。回顾性收集并分析了血脂浓度、血肿体积和其他临床特征。采用 ABC/2 法在首次头颅影像学检查时测量血肿体积。LDL-C 浓度从 ICH 发生前最后一次体格检查中获得。根据四分位数将 LDL-C 浓度分为四组。采用 Logistic 回归评估 LDL-C 浓度与血肿体积增大风险之间的关系。采用广义线性回归模型分析 LDL-C 浓度与血肿体积之间的剂量-反应关系。

结果

共评估了 836 例 ICH 患者。多变量 logistic 回归分析显示,与 LDL_C 第二四分位相比,LDL-C 第一四分位发生大血肿的风险显著升高(OR 2.49[95%CI 1.54-4.01]),而 LDL_C 更高四分位与大血肿体积的高比值无关。在广义线性回归模型中,LDL-C 浓度与血肿体积之间的调整β为 9.46(95%置信区间 2.87-16.04),而较高的 LDL-C 浓度与大血肿体积无关。

结论

本研究证实,ICH 前较低的 LDL-C 浓度与较大血肿体积的风险增加有关。

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Clinical Characteristics and Outcomes of Intracerebral Hemorrhage in Very Elderly.高龄脑出血患者的临床特征及预后
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