进展性缺血性脑卒中与血脂水平的分层研究

发布时间：2018-01-03 08:42

  本文关键词：进展性缺血性脑卒中与血脂水平的分层研究　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： 进展性卒中 危险因素 血脂水平

【摘要】：背景及目的：进展性缺血性卒中（progressive ischemic stroke，PIS）简称进展性卒中（stroke in progression，SIP）是指发病6h后，无论是否接受治疗病情仍逐渐进展恶化甚至死亡的急性脑梗死。进展性卒中严重影响卒中患者的预后，由于缺乏有效地治疗措施，其致残率、死亡率都明显高于非进展性脑梗死。因此，提高对SIP的认识，尽早对其危险因素进行干预，，对改善脑血管病的预后，降低致残率和死亡率，有重要意义。本研究通过SIP组和非SIP组的对比，探索血脂水平变化与SIP发生发展的关系。 方法：对入组的194例患者一般临床资料、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白检测结果，采用Epidata3.1建立数据库，SPSS17.0统计软件进行资料的统计分析。符合正态分布的计量资料采用X±S表示其集中趋势和离散趋势，组间比较采用t检验；不符合正态分布的计量资料采用M±Q表示其集中趋势和离散趋势，组间比较用秩和检验；计数资料用率或构成比表示，组间比较采用χ2检验。 结果：1.（1）血清3.84mmol/L≤TC＜4.66mmol/L者SIP发生率（71.0%）高于TC＜3.84mmol/L者（33.3%），血清3.84mmol/L≤TC＜4.66mmol/L者SIP发生率（71.0%）高于TC≥4.66mmol/L者（53.7%）。（2）血清TC＜3.84mmol/L者SIP发生率（33.3%）低于非SIP（66.7%），3.84mmol/L≤TC＜4.66mmol/L者SIP发生率（71.0%）高于非SIP（29.0%）。2.血清0.85mmol/L≤TG＜1.16mmol/L者SIP发生率(71.1%)高于TG＜0.85mmol/L者（33.3%）。3.血清LDL-C≥4.39mmol/L者SIP发生率(83.3%)高于2.90mmol/L≤LDL-C＜4.39mmol/L者（50.5%），血清LDL-C≥4.39mmol/L者SIP发生率（83.3%）高于LDL-C＜2.90mmol/L者（58.2%）。4.血清HDL-C＜1.16mmol/L者SIP发生率（60.4%）高于1.16mmol/L≤HDL-C＜1.28mmol/L者(36.4%)。5.（1）血清0.13mmol/L≤Lpa＜0.37mmol/L者SIP发生率(68.9%)高于Lpa＜0.13mmol/L者（39.3%）。（2）血清Lpa＜0.13mmol/L者SIP发生率（39.3%）低于非SIP（60.7%），0.13mmol/L≤Lpa＜0.37mmol/L者SIP发生率（68.9%）高于非SIP（31.1%）。 结论：1、血清TC和Lpa在低水平时SIP发病率低于非SIP，在中水平时SIP发病率高于非SIP，故将血清TC控制在3.84mmol/L以下，血清Lpa控制在0.13mmol/L以下，有利于预防卒中进展。2、血清TG、LDL-C和HDL-C处在任一水平，SIP与非SIP发病率无明显差别。3、血清TC在中水平时，SIP发生率最高；血清LDL-C在高水平时，SIP发生率最高；血清TG和Lpa在中水平时，SIP发生率高于在低水平时；血清HDL-C在低水平时，SIP发生率高于在中水平时。4、初步建立了进展性卒中血脂水平评估量表，在临床应用中，可根据此表预测进展性卒中发生风险。
[Abstract]:Background & AIM: progressive ischemic stroke in progressive ischemic stroke. PIS) refers to 6 hours after onset of stroke in progression. Progressive stroke seriously affects the prognosis of stroke patients, and the disability rate is due to the lack of effective treatment. The mortality rate was significantly higher than that of non-progressive cerebral infarction. Therefore, to improve the prognosis of cerebrovascular disease and reduce disability rate and mortality, we should improve the understanding of SIP and intervene its risk factors as early as possible. Through the comparison between SIP group and non-SIP group, the relationship between the changes of blood lipid level and the occurrence and development of SIP was explored. Methods: the general clinical data of 194 patients were analyzed. Serum total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and lipoprotein were detected. The statistical software SPSS 17.0 was used to establish the database with Epidata3.1. The measurement data in accordance with the normal distribution were expressed by X 卤S as the concentrated trend and the discrete trend. T test was used for comparison between groups. M 卤Q was used to indicate the trend of concentration and dispersion, and the rank sum test was used for the comparison between groups. The counting data were expressed by rate or composition ratio, and 蠂 2 test was used for comparison between groups. Results the incidence of SIP in 3.84 mmol / L 鈮

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