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血脂水平对急性脑卒中患者静脉血栓栓塞的影响。

Impact of blood lipid levels on venous thromboembolism in acute stroke patients.

机构信息

Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang, China; Department of General Practice, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang 322100, Zhejiang, China.

Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, 112 Nanliu Road, ChaShan High Education Zone, Wenzhou 325000, Zhejiang Province, China.

出版信息

J Clin Neurosci. 2024 Apr;122:53-58. doi: 10.1016/j.jocn.2024.02.015. Epub 2024 Mar 13.

Abstract

BACKGROUND

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication of stroke with a high incidence of underdiagnosis. The relationship between dyslipidemia and VTE remains uncertain. Therefore, this study aimed to explore this connection in acute stroke patients to enhance diagnostic and preventative strategies.

METHODS

Retrospective data from 7854 acute stroke patients admitted to Dongyang Hospital, Affiliated with Wenzhou Medical University, between 2010 and 2020 were extracted. Differential tests were compared among various blood lipid parameters and the presence or absence of venous thrombosis. Logistic regression analysis was employed to estimate associations.

RESULTS

The prevalences of DVT and PE were 3.9 % and 1.1 %, respectively. Additionally, 43 cases (0.5 %) exhibited combined DVT and PE. A high triglyceride (TG) level was associated with a decreased risk of VTE (adjusted odd ratio [aOR] = 0.69, 95 % confidence interval [CI]: 0.54-0.89, P = 0.004), whereas a high low-density lipoprotein cholesterol (LDL-C) level was associated with an increased risk of VTE (aOR = 1.51, 95 % CI: 1.16-1.97, P = 0.002), after adjusting for confounding factors. No significant associations were observed for high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels with VTE risk. Subgroup analyses revealed that these associations were significant in ischemic stroke patients.

CONCLUSION

Low TG levels and high LDL-C levels were found to be associated with an increased risk of VTE in acute stroke patients, offering valuable insights for the early identification and management of high-risk individuals.

摘要

背景

静脉血栓栓塞症(VTE),包括深静脉血栓形成(DVT)和肺栓塞(PE),是中风的常见并发症,漏诊率较高。血脂异常与 VTE 之间的关系尚不确定。因此,本研究旨在探讨急性中风患者中这种关系,以增强诊断和预防策略。

方法

从 2010 年至 2020 年,从温州医科大学附属东阳医院收治的 7854 例急性中风患者中提取回顾性数据。对各种血脂参数与静脉血栓形成之间的差异进行了比较。采用 logistic 回归分析来估计关联。

结果

DVT 和 PE 的患病率分别为 3.9%和 1.1%。此外,43 例(0.5%)患者同时患有 DVT 和 PE。高甘油三酯(TG)水平与 VTE 风险降低相关(调整后的优势比[aOR]为 0.69,95%置信区间[CI]为 0.54-0.89,P=0.004),而高低密度脂蛋白胆固醇(LDL-C)水平与 VTE 风险增加相关(aOR 为 1.51,95%CI 为 1.16-1.97,P=0.002),在调整混杂因素后。高密度脂蛋白胆固醇(HDL-C)和总胆固醇(TC)水平与 VTE 风险无显著相关性。亚组分析显示,这些关联在缺血性中风患者中具有统计学意义。

结论

在急性中风患者中,低 TG 水平和高 LDL-C 水平与 VTE 风险增加相关,为早期识别和管理高危人群提供了有价值的信息。

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