LDL-C/HDL-C比值及颈动脉粥样硬化性狭窄与脑梗塞发病关系的探讨

目的 研究低密度脂蛋白胆固醇(LDL-C)／高密度脂蛋白胆固醇(HDL-C)比值以及颈动脉粥样硬化性狭窄与脑梗塞发病的关系，并探讨其预测脑梗塞发生的价值。方法 应用彩色多普勒显保仪对非脑梗塞组患者328例(高血压198例、糖尿病82例、高血压伴糖尿病48例)和脑梗塞组患者260例进行颈动脉检测，观察颈动脉狭窄程度；同时检测两组患者的LDL-C/HDL-C比值水平。结果 脑梗塞组颈动脉重度狭窄发生率明显高于非脑梗塞组(P＜0．01)；LDL-C/HDL-C比值水平及异常率也明显高于非脑梗塞组(P＜0．01)，相关分析显示与甘油三酯(TG)、总胆固醇(Tch)、LDL和HDL-C相比，该比值显示了更有意义的与脑梗塞的相关关系(β＝0．357，P＝0．001)，经多元逐步回归分析显示，与TG、Tch、LDL-C和HDL-C相比，该比值显示了更有意义的回归关系，其标准方程式为：γ(脑梗塞)＝0．339(糖尿病史) 0．278(LDL-C) 0．187(高血压史)(P＜0．贴，复相关系数为0．534)。结论 应用颈动脉超声判定颈动脉重度狭窄和检测LDL-C/HDL-C比值水平及异常率对预测脑梗塞的发生有一定的实用参考价值。

The predictive value of incidence of cerebral infarction in patients with carotid stenosis and changes of LDL- C/HDL- C ratio

Objective To study the association between cerebral infarction with serum low density lipoprotein-cholesterol/high density lopoprotein-cholesterol (LDL-C/HDL-C) ratio and carotid stenosis, so as to explore the predictive value in incidence of cerebral infarction. Methods 328 patients (198 patients with hypertension, 82 patents of diabetes mellitus, 48 patients of hypertension combined with diabetes mellitus) and 260 patients with cerebral infarction were detected by Color-Doppler ultrasound and LDL-C/HDL-C ratio was analysed. Results The incidence of severe carotid stenosis in the group of cerebral infarction was obviously higher than that of non-cerebral infarction ( P <0.01) and LDL-C/HDL-C ratio was significantly lower than that of patients with cerebral infarction ( P <0.01). Multivariate regression analysis revealed that LDL-C/HDL-C ratio had a significantly variable association with cerebral infarction compared with either Tch or TG as well as LDL-C (or) HDL-C. Conclusion The level and abnormal rates of LDL-C/HDL-C ratio and ultrasonic reference have important value in forecast incidence of cerebral infarction.