[1]韩晶晶,杨 帆,周旭强,等.急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究[J].现代检验医学杂志,2020,35(03):42-46.[doi:10.3969/j.issn.1671-7414.2020.03.010]
 HAN Jing-jing,YANG Fan,ZHOU Xu-qiang,et al.Study on the Correlation between Low Density Lipoprotein (LDL) Cholesterol Level and the Severity of Cardiovascular and Cerebrovascular Stenosis in Patients with Acute Ischemic Stroke[J].Journal of Modern Laboratory Medicine,2020,35(03):42-46.[doi:10.3969/j.issn.1671-7414.2020.03.010]
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急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇水平与心脑血管狭窄程度的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年03期
页码:
42-46
栏目:
论著
出版日期:
2020-07-20

文章信息/Info

Title:
Study on the Correlation between Low Density Lipoprotein (LDL) Cholesterol Level and the Severity of Cardiovascular and Cerebrovascular Stenosis in Patients with Acute Ischemic Stroke
文章编号:
1671-7414(2020)03-042-05
作者:
韩晶晶1杨 帆2周旭强3陆怡德1
(1. 上海交通大学医学院附属瑞金医院无锡分院检验科,江苏无锡 214000;2. 上海交通大学医学院附属瑞金医 院检验科,上海 200025;3. 苏州市吴江区中西结合医院检验科,江苏苏州 215200)
Author(s):
HAN Jing-jing1 YANG Fan2 ZHOU Xu-qiang3 LU Yi-de1
(1. Department of Clinical Laboratory, Wuxi Branch of Ruijin Hospital, Medical College of Shanghai Jiaotong University, Jiangxi Wuxi 214000, China;2. Department of Clinical Laboratory, Ruijin Hospital of Medical College, Shanghai Jiaotong University, Shanghai 200025, China;3. Department of Clinical Laboratory, Wujiang District Hospital of Combining Chinese and Western Medicine, Jiangsu Suzhou 215200, China)
关键词:
小而密低密度脂蛋白胆固醇 急性缺血性脑卒中心脑血管狭窄程度
分类号:
R743.3;R446.112
DOI:
10.3969/j.issn.1671-7414.2020.03.010
摘要:
目的 研究急性缺血性脑卒中患者血清小而密低密度脂蛋白胆固醇(small and low density lipoprotein cholesterol,sdLDL-C)与心脑血管狭窄程度的相关性。方法 收集上海市交通大学附属瑞金医院神经内科2015 年5 月 ~2017 年10 月期间,已确诊为缺血性脑卒中患者146 例。按照其血管造影(MRA)和颈部超声结果,分为血管正常组 18 例、血管闭塞组34 例和血管狭窄组94 例( 包括血管单支狭窄组28 例、血管多支狭窄组66 例),分别检测其血清胆 固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[Lp(a)] 和小而密 低密度脂蛋白胆固醇(sdLDL-C)水平。另选取对照组112 例。比较各组间sdLDL-C 的检测结果,并用多元logistic 回 归分析各检测项目与急性缺血性脑卒中的关系。结果 病例组中TG,Lp(a) 和sdLDL-C 明显高于对照组,差异均具有 统计学意义(t=-6.011, -2.776, -3.744,均P < 0.05);对照组的HDL-C 明显高于病例组,差异具有统计学意义(t=9.665, P < 0.05);TG,Lp(a),sdLDL-C 和sdLDL-C/LDL-C 比值与急性缺血性脑卒中的发生呈正相关(相关系数分别为0.316, 0.166,0.20,0.243);血管闭塞组sdLDL-C 的血清水平(33.77±14.57mmol/L)明显高于血管正常组sdLDL-C 的血 清水平(25.38±12.29mmol/L);血管多支狭窄组sdLDL-C 的血清水平(30.10±13.61 mmol/L)明显高于单支狭窄组 (20.88±6.46 mmol/L);血管闭塞组LDL-C,sdLDL-C 明显高于血管正常组和血管狭窄组,差异具有统计学意义(F=3.34, 3.719, 均P<0.05);多支狭窄组血清TG,TG,LDL-C,sdLDL-C 和sdLDL-C/LDL-C 结果均高于单支狭窄组,差异均 具有统计学意义(t=-3.381, -2.372, -2.17,-4.323,-2.193,均P < 0.05)。结论 急性缺血性脑卒中患者sdLDL-C 水 平升高,且升高水平与血管病变程度密切相关。
Abstract:
Objective To study the value of small and low density lipoprotein cholesterol (sdLDL-C) in the diagnosis of patients with acute ischemic stroke and its correlation with other risk factors in the occurrence of acute ischemic stroke. Methods From May 2015 to October 2017, 146 patients with ischemic stroke were collected in the Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University. According to the results of MRA and neck ultrasound, the patients were divided into normal vascular group (18 cases), occluded vascular group (34 cases) and stenotic vascular group (94 cases: single vessel stenosis group/28 cases and multi vessel stenosis group/66 cases). The levels of TC, TG, HDL-L, LDL-C, Lp(a) and sdLDL-C were measured. In the control group, 112 healthy people were selected to test the sdLDL-C level studied in this experiment, and the correlation between sdLDL-C and acute ischemic stroke was explored. Results TG, Lp(a) and sdLDL-C in the case group were significantly higher than those in the control group, with statistically significant differences (t=-6.011, -2.776, -3.744, all P < 0.05). HDL-C in the control group was significantly higher than that in the case group, with statistically significant difference (t=9.665, P < 0.05).TG, Lp(a), sdLDL-C and sdLDL-C/LDL-C ratios were positively correlated with the occurrence of acute ischemic stroke (correlation coefficients were 0.316, 0.166, 0.20, and 0.243, respectively). The serum level of sdLDL-C in the occluded group (33.77±14.57mmol/L) was significantly higher than that in the normal vascular group (25.38±12.29mmol/L). The serum level of sdLDL-C in the multi-vessel stenosis group (30.10±13.61 mmol/L) was significantly higher than that in the single-vessel stenosis group (20.88±6.46 mmol/L). LDL-C and sdLDL-C in the vascular occlusion group were significantly higher than those in the normal vascular group and the vascular stenosis group (F=3.34, 3.719, all P<0.05), with statistically significant differences. Results of serum TG, TG, LDL-C, sdLDL-C and sdLDL-C/LDL-C in the multibranch stenosis group were all higher than those in the single-branch stenosis group, with statistically significant differences (t=-3.381, -2.372, -2.17, -4.323 and -2.193, all P < 0.05). Conclusion sdLDL-C and stroke disease had high correlation, could a high level of sdLDL-C could indicate the damage of the vessel.

参考文献/References:

[1] 兰卫明,麻乐乐,缺血性脑卒中患者血清Chemerin 因子表达及其临床意义[J]. 中国临床药理学杂志, 2016, 32(15): 1353-1355.    LAN Weiming, MA Lele.Expression and clinical significance of serum Chemerin in patients with ischemic stroke [J].Chinese Journal of Clinical Pharmacology, 2016,32(15):1353-1355.
[2] 高宏娥,李荫桂,黄海云,等. 缺血性脑卒中患者 血浆脂蛋白相关磷脂酶A2 测定的临床意义[J]. 现 代检验医学杂志,2015, 30(2): 58-60,64.    GAO Honge, LI Yinggui, HUANG Haiyun, et al. Clinical significance of plasma lipoprotein associated phospholipase A2 detecting in patients with ischemic cerebral stroke [J].Journal of Modern Laboratory Medicine,2015,30(2):58-60,64
[3] 崔英华,汪道文. 小而密低密度脂蛋白胆固醇与脑 卒中、急性冠脉综合征及其危险因素的关系[D]. 武汉:华中科技大学,2004.    CUI Yinghua, WANG Daowen, Association of small dense low-density lipoproteins with stroke or acute, coronary syndrome and other risk factors of stroke or acute cornary syndrome [D]. Wuhai: Huazhong University of Science and Technology, 2004.
[4] MILLER B D, ALDERMAN E L,HASKEOLL W L,et al. Predominance of dense low-density lipoprotein particles predics angiographic benefit of therapy in the stanford coronary risk intervention project[J]. Circulation, 1996, 94(9): 2146-2153.
[5] KRAUSS R M. Dietary and genetic effects on low-density lipoprotein heterogeneity[J]. Ann Rev Nutr, 2001, 21:283-295.
[6] AUSTIN M A,BRUNZELL J D, FITCH W L,et al. Inheritance of Low-density lipoprotein subclass patterns in familial cobined hyperlipidemia[J]. Atherose lerosis.1990,10(4):520-530.
[7]  王刚林,张淑香,潘能科,等. 小而密低密度脂蛋 白胆固醇临床研究进展[J]. 检验医学与临床,2015, 12(12): 1804-1806.    WANG Ganglin, ZHANG Shuxiang, PAN Nengke, et al. Clinical research progress of small and dense LDL cholesterol[J]. Laboratory Medicine and Clinic, 2015, 12(12): 1804-1806.
[8]  STEERLE S R, KUMAR R, FEINGOLD D L, et al.Practice parameters for the manangement of perianal abscess and fistula-inano [J].Dis Colon Rectum, 2011, 54(12): 1465-1474.
[9]  陈伟伟,高润霖,刘力生,等.中国心血管病报告 2015 概要[J].中国循环杂志,2016, 31(6): 521- 528.    CHEN Weiwei, GAO Runlin, LIU Lisheng, et al. China cardiovascular disease report 2015 summary [J]. Chinese circulation Journal, 2016, 31(6):521-528.
[10] 中华医学会神经病学分会,中华医学会神经病学分 会脑血管病学组. 中国急性缺血性脑卒中诊治指南 2014[J]. 中华神经科杂志,2015,48(4):246-257.    Chinese Society of Neurology, Chinese Medical Association, Cerebrovascular Division, Neurology Branch, Chinese Medical Association, Chinese Stroke Society. Guidelines for the diagnosis and treatment of acute ischemic stroke in China(2014)[J].Chinese Journal of Neurology,2015, 484(4): 246-257.
[11] National Cholesterol Education Program in Adults. Executive summary of the third report of the National Cholesterol Education Program(NCEP)expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)[J]. Journal of the American Medical Association, 2001, 285(19):2488-2497.
[12] KWITEROVICH P O. Clinical relevance of the biochemical, metabolic, and genetic factors that influence low-density lipoprotein heterogeneity[J]. Am J Cardiol, 2002,90(8A):30-47.
[13] 尚红,王毓三,申子瑜. 全国临床检验操作规程[S].4 版. 北京: 人民卫生出版社,2014:323.    SHANG Hong, WANG Yusan, SHEN Ziyu. National guide to Clinical Laboratory Procedares[S]. 4th Ed. Beijing: People’s Medical Publishing House, 2014:323.
[14] 邹大进. 从循证医学看糖尿病降脂治疗的意义[J]. 国 际内分泌代谢杂志,2004, 24(3): 6-7.    ZOU Dajin. The significance of diabetes lipid-lowering therapy from evidence-based medicine[J]. International Journal of Endocrinology and Metabolism, 2004, 24(3): 6-7.
[15] GERBER P A, SPINA G A, BERNIS K. Small dense low-density lipoprotein particles: Priority as a treatment target in Type 2 diabetes [J] .Diabetes Management, 2012,2 (1):65-74.
[16] 张民乐.sdLDL 在冠心病发病中的作用及与冠状 动脉狭窄程度的关系[J],国际检验医学杂志, 2017,38(18):2619-2622.    ZHANG Minle, The role of sdLDL in the pathogenesis of coronary heart disease and its relationship with the degree of coronary artery stenosis[J]. International Journal of Laboratory Medicine,2017,38(18):2619-2622.
[17] 范雪松,王恩世,贺建勋, 等. 小而密低密度脂蛋 白胆固醇及其与低密度脂蛋白胆固醇之比与颈动 脉粥样硬化斑块的关系[J]. 中华检验医学杂志, 2018,41(3):219-226.    FAN Xuesong, WANG Enshi, HE Jianxun, et al. Small dense low-density lipoprotein cholesterol and sdLDL-C/ LDL-C ratio associate with carotid atherosclerotic plaque[J]. Chinese Journal of Laboratory Medicine, 2018, 41(3):219-226.

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备注/Memo

备注/Memo:
收稿日期:2020-01-08 修回日期:2020-03-02作者简介:韩晶晶(1992-),女,本科,理学学士,初级检验师,主要从事临床生物化学工作,E-mail:785852943@qq.com。 通讯作者:陆怡德,E-mail:yidelu@sina.com。
更新日期/Last Update: 2020-07-20