血脂水平与缺血性脑卒中认知预后的关系研究

目的　探讨血脂水平与缺血性脑卒中认知预后的关系。方法　对序贯收集的首次发病急性缺血性脑卒中患者做血脂全套分析，用MMSE进行认知功能随访。对发病后三个月MMSE评分与血脂指标进行单因素及多因素分析。结果　认知评分较低组TG、TC、ApoB、LDL-C显著较高。TG、TC、ApoB、LDL-C机遇比分别为4.37（95%CI 0.08～0.64）、3.35(2.25～4.99)、3.95(0.05～1.41)、6.68(0.05～0.45)。多元逐步回归方程：三个月的MMSE评分=37.655-0.075年龄-2.015ApoB-0.930LDL-C-2.014梗塞个数。结论　血脂水平与缺血性脑卒中认知预后密切相关，LDL-C及ApoB是预测缺血性脑卒中认知预后的独立变量。

Association of lipid profile with cognitive impairment after ischaemic cerebrovascular diseases

Objective　To investigate the association of serum lipid profile with cognitive change in patients with ischaemic cerebrovascular disorder. Methods　 The fasting serum concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density cholesterol and triglyceride were measured in 69 consecutive systematically investigated patients with ischaemic cerebrovascular disorder verified by MRI/CT. The 30-point Mini-Mental State Examination (MMSE) was used to determine cognitive change. The relationship between serum lipid profile and cognitive status of ischaemic stroke survivors were evaluated using multiple stepwise regression analysis. Results　The patients with lower MMSE scores (≤24) at 3rd month after first-ever stroke had significantly higher triglyceride, total cholesterol, apolipoprotein B and low density lipoprotein cholesterol levels than others. Odds ratios with TG, TC , ApoB and LDL-C ( 95% confidence interval) for cognitive impairment was 4.37 ( 0.08～0.64 )，3.35 (2.25～4.99 )，3.95 (0.05～1.41) and 6.68 (0.05～0.45), respectively. Stepwise multiple regression revealed age infarct numbers,LDL-C and ApoB were in association with the better predictor of cognitive scores at 3rd month after stroke. The MMSE scores = 37.655－0.075 age－2.015 ApoB－0.93 LDL-C－2.014 infarct number. Conclusion　The data suggest lipid profile was association with cognitive impairment in patients with ischemic stroke. Except for age and infarct numbers, LDL-C and ApoB levels appear to be independent variables for predicting cognitive prognosis in patients with ischemic stroke.