大动脉粥样硬化性脑梗死患者血脂性别差异的多中心横断面研究

目的研究大动脉粥样硬化性(LAA)脑梗死相关血脂指标的性别差异。方法选择中国国家卒中登记数据库中4189例首发脑梗死患者,依据TOAST病因学分型分为LAA组1919例、小血管闭塞(SVO)组716例和非LAA&SVO组1554例。分析TG、TC、HDL-C、LDL-C水平与LAA的相关性。结果 3组除TG外,女性TC、HDL-C、LDL-C水平均高于男性(P<0.01)。LAA组vs非LAA组,LAA组vs非LAA&SVO组的2个logistic回归模型分析均显示:TC、LDL-C水平与LAA发生相关。男性患者TG水平与LAA的相关性有显著意义,TG每升高1个四分位数区间,LAA组较非LAA组、非LAA&SVO组发生的可能性分别增加8.6%和15.0%。结论相较于其他缺血性脑卒中亚型,TC、LDL-C增高与LAA的发生密切相关;TG在预测颅内外LAA风险时,存在性别差异,对于男性除常规关注TC、LDL-C外,还需将TG考虑在内。

Multicenter cross-sectional study on blood lipid-associated gender difference in patients with large artery atherosclerotic ischemic stroke

Objective To study the blood lipid-associated gender difference in patients with large artery atherosclerosis(LAA) ischemic stroke.Methods A total of 4189 first-ever ischemic stroke patients,selected from China National Stroke Registry,were divded into LAA ischemic stroke group(n=1919),small vessel occlusion(SVO) group(n=716),and non-LAA&SVO group(n=1554) according to the TOAST etiological classification.Correlation of serum TG,TC,HDL-C and LDL-C levels with LAA was analyzed.Results The serum TC,HDL-C and LDL-C levels were significantly higher in female LAA ischemic stroke patients than in male LAA ischemic stroke patients(P<0.01).Logistic regression analysis showed that the serum TC,HDL-C and LDL-C levels were correlated with the occurrence of LAA.The serum TG level was closely correlated with LAA in male patients.Conclusion Elevated serum TC and LDL-C levels are closely correlated with LAA in ischemic stroke patients.There is a gender difference when serum TG level is used as a predictor for the risk of LAA.Besides serum TC and LDL-C levels,serum TG level should thus be considered in male LAA ischemic stroke patients.