国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2015年
1期
27-31
,共5页
载脂蛋白B%载脂蛋白A-Ⅰ%卒中%脑缺血%颅内动脉硬化%生物学标记%危险因素
載脂蛋白B%載脂蛋白A-Ⅰ%卒中%腦缺血%顱內動脈硬化%生物學標記%危險因素
재지단백B%재지단백A-Ⅰ%졸중%뇌결혈%로내동맥경화%생물학표기%위험인소
Apolipoprotein B%Apolipoprotein AⅠ%Stroke%Brain Ischemia%Intracranial Arteriosclerosis%Biological Markers%Risk Factors
目的 探讨载脂蛋白(apolipoprotein B,ApoB)、载脂蛋白AⅠ(apolipoproteinA Ⅰ,ApoA Ⅰ)和ApoB/ApoA Ⅰ比值与缺血性卒中患者颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)的关系.方法 回顾性收集大动脉粥样硬化性卒中患者,基于血管影像学资料将患者分为ICAS组和非ICAS组,收集血压、血脂、血糖、ApoB、ApoA Ⅰ、ApoB/ApoA Ⅰ比值以及人口统计学资料,比较上述指标在两组之间的差异.结果 共纳入360例大动脉粥样硬化性卒中患者,ICAS组177例(49.2％),非ICAS组183例(50.8％).两组之间高血压、糖尿病和冠心病的患者构成比以及低密度脂蛋白胆固醇、ApoB、ApoA Ⅰ水平和ApoB/ApoA Ⅰ比值存在显著性差异(P均＜0.05).多变量logistic回归分析显示,高血压[优势比(odds ratio,OR)1.75,95％可信区间(confidence interval,CI)1.04 ～2.93;P=0.035]、糖尿病(OR 2.09,95％ CI 1.31 ～3.32;P=0.002)、冠心病(OR 2.68,95％ CI1.09 ～6.57;P=0.031)以及ApoB≥0.84 g/L(0.84 ～ 1.00 g/L:OR 2.68,95％ CI 1.30 ～ 5.56; 1.00 ～1.16 g/L:OR 3.95,95％ CI 1.87 ～8.40;＞ 1.00 g/L:OR6.41,95％ CI 2.82 ～ 14.49)和ApoB/ApoA Ⅰ比值≥0.60(0.60～0.73:OR 1.92,95％ CI 1.14 ～3.24;0.74～0.91:OR 1.79,95％ CI 1.06 ～3.02;＞0.91:OR 3.30,95％ CI 1.92 ～5.67)为ICAS的独立危险因素,而ApoA Ⅰ＞1.28 g/L为ICAS的独立保护因素(OR0.39,95％ CI0.16～0.98;P=0.044).结论 在急性缺血性卒中患者中,ApoB水平和ApoB/ApoA Ⅰ比值增高是ICAS的独立危险因素,而ApoA Ⅰ水平增高为ICAS的独立保护因素.ApoB/ApoA Ⅰ比值可作为中国人群缺血性卒中患者ICAS的生物学标记物.
目的 探討載脂蛋白(apolipoprotein B,ApoB)、載脂蛋白AⅠ(apolipoproteinA Ⅰ,ApoA Ⅰ)和ApoB/ApoA Ⅰ比值與缺血性卒中患者顱內動脈粥樣硬化性狹窄(intracranial atherosclerotic stenosis,ICAS)的關繫.方法 迴顧性收集大動脈粥樣硬化性卒中患者,基于血管影像學資料將患者分為ICAS組和非ICAS組,收集血壓、血脂、血糖、ApoB、ApoA Ⅰ、ApoB/ApoA Ⅰ比值以及人口統計學資料,比較上述指標在兩組之間的差異.結果 共納入360例大動脈粥樣硬化性卒中患者,ICAS組177例(49.2％),非ICAS組183例(50.8％).兩組之間高血壓、糖尿病和冠心病的患者構成比以及低密度脂蛋白膽固醇、ApoB、ApoA Ⅰ水平和ApoB/ApoA Ⅰ比值存在顯著性差異(P均＜0.05).多變量logistic迴歸分析顯示,高血壓[優勢比(odds ratio,OR)1.75,95％可信區間(confidence interval,CI)1.04 ～2.93;P=0.035]、糖尿病(OR 2.09,95％ CI 1.31 ～3.32;P=0.002)、冠心病(OR 2.68,95％ CI1.09 ～6.57;P=0.031)以及ApoB≥0.84 g/L(0.84 ～ 1.00 g/L:OR 2.68,95％ CI 1.30 ～ 5.56; 1.00 ～1.16 g/L:OR 3.95,95％ CI 1.87 ～8.40;＞ 1.00 g/L:OR6.41,95％ CI 2.82 ～ 14.49)和ApoB/ApoA Ⅰ比值≥0.60(0.60～0.73:OR 1.92,95％ CI 1.14 ～3.24;0.74～0.91:OR 1.79,95％ CI 1.06 ～3.02;＞0.91:OR 3.30,95％ CI 1.92 ～5.67)為ICAS的獨立危險因素,而ApoA Ⅰ＞1.28 g/L為ICAS的獨立保護因素(OR0.39,95％ CI0.16～0.98;P=0.044).結論 在急性缺血性卒中患者中,ApoB水平和ApoB/ApoA Ⅰ比值增高是ICAS的獨立危險因素,而ApoA Ⅰ水平增高為ICAS的獨立保護因素.ApoB/ApoA Ⅰ比值可作為中國人群缺血性卒中患者ICAS的生物學標記物.
목적 탐토재지단백(apolipoprotein B,ApoB)、재지단백AⅠ(apolipoproteinA Ⅰ,ApoA Ⅰ)화ApoB/ApoA Ⅰ비치여결혈성졸중환자로내동맥죽양경화성협착(intracranial atherosclerotic stenosis,ICAS)적관계.방법 회고성수집대동맥죽양경화성졸중환자,기우혈관영상학자료장환자분위ICAS조화비ICAS조,수집혈압、혈지、혈당、ApoB、ApoA Ⅰ、ApoB/ApoA Ⅰ비치이급인구통계학자료,비교상술지표재량조지간적차이.결과 공납입360례대동맥죽양경화성졸중환자,ICAS조177례(49.2％),비ICAS조183례(50.8％).량조지간고혈압、당뇨병화관심병적환자구성비이급저밀도지단백담고순、ApoB、ApoA Ⅰ수평화ApoB/ApoA Ⅰ비치존재현저성차이(P균＜0.05).다변량logistic회귀분석현시,고혈압[우세비(odds ratio,OR)1.75,95％가신구간(confidence interval,CI)1.04 ～2.93;P=0.035]、당뇨병(OR 2.09,95％ CI 1.31 ～3.32;P=0.002)、관심병(OR 2.68,95％ CI1.09 ～6.57;P=0.031)이급ApoB≥0.84 g/L(0.84 ～ 1.00 g/L:OR 2.68,95％ CI 1.30 ～ 5.56; 1.00 ～1.16 g/L:OR 3.95,95％ CI 1.87 ～8.40;＞ 1.00 g/L:OR6.41,95％ CI 2.82 ～ 14.49)화ApoB/ApoA Ⅰ비치≥0.60(0.60～0.73:OR 1.92,95％ CI 1.14 ～3.24;0.74～0.91:OR 1.79,95％ CI 1.06 ～3.02;＞0.91:OR 3.30,95％ CI 1.92 ～5.67)위ICAS적독립위험인소,이ApoA Ⅰ＞1.28 g/L위ICAS적독립보호인소(OR0.39,95％ CI0.16～0.98;P=0.044).결론 재급성결혈성졸중환자중,ApoB수평화ApoB/ApoA Ⅰ비치증고시ICAS적독립위험인소,이ApoA Ⅰ수평증고위ICAS적독립보호인소.ApoB/ApoA Ⅰ비치가작위중국인군결혈성졸중환자ICAS적생물학표기물.
Objective To investigate the relationship between apolipoprotein B (ApoB),apolipoprotein A Ⅰ (ApoA Ⅰ) and their ratios and intracranial cerebral atherosclerotic stenosis (ICAS) in patients with acute ischemic stroke.Methods The patients with large artery atherosclerotic stroke were enrolled retrospectively.The patients were divided into either an ICAS group or a non-ICAS group based on their vascular imaging data.The blood pressure,blood lipids,blood glucose,ApoB,ApoA Ⅰ,and ApoB/ApoA Ⅰ ratios and demographic data were collected.The differences of the above indicators were compared between the two groups.Results A total of 360 patients with large artery atherosclerotic stroke were enrolled.There were 177 patients in the ICAS group (49.2％) and 183 in the non-ICAS group (50.8％).There were significant differences in the constituent ratios of the patients with hypertension,diabetes and coronary heart disease,as well as the levels of low-density lipoprotein cholesterol,ApoB and ApoA Ⅰ and ApoB/ApoA Ⅰ ratios between the 2 groups (all P ＜0.05).Multivariable logistic regression analysis showed that hypertension (odds ratio [OR] 1.75,95％ confidence interval [CI] 1.04-2.93; P =0.035),diabetes mellitus (OR 2.09,95％ CI 1.31-3.32; P =0.002),coronary heart disease (OR 2.68,95％ CI 1.09-6.57; P =0.031),ApoB ≥ 0.84 g/L (0.84-1.00 g/L:OR 2.68,95％ CI 1.30-5.56; 1.00-1.16 g/L:OR 3.95,95％ CI 1.87-8.40; ＞ 1.00 g/L:OR 6.41,95％ CI 2.82-14.49) and ApoB/ApoA Ⅰ ratio ≥0.60 (0.60-0.73:OR 1.92,95％ CI 1.14-3.24; 0.74-0.91:OR 1.79,95％ CI 1.06-3.02; ＞0.91:OR 3.30,95％ CI 1.92-5.67) were the independent risk factors for ICAS,while ApoA Ⅰ ＞ 1.28 g/L was an independent protective factor for ICAS (OR 0.39,95％ CI 0.16-0.98; P=0.044).Conclusions The increased ApoB level and ApoB/ApoA Ⅰ ratio are the independent risk factors for ICAS,and the increased ApoA Ⅰ level is an independent protective factor for ICAS in patients with acute ischemic stroke.The ApoB/ApoA Ⅰ ratio can be used as a biomarker of ICAS in patients with ischemic stroke in Chinese population.
