摘要： 探讨低密度脂蛋白胆固醇/高密度脂蛋白胆固醇（LDL-C/HDL-C）比值与缺血性卒中相关危险因素的关系及其对发病3 个月时结局的影响。共150 例非心源性急性缺血性卒中患者，根据入院时LDL-C/HDL-C 比值分为LDL-C/HDL-C ≤ 3 组和LDL-C/HDL-C > 3 组，两组患者糖尿病史、冠心病史、吸烟史和颈动脉粥样硬化斑块等危险因素阳性检出率差异有统计学意义（均P < 0.05）。经多因素逐步Logistic 回归分析，LDL-C/HDL-C > 3（OR = 1.781，95%CI：1.343 ~ 2.374；P = 0.001）和NIHSS 评分（OR = 1.923，95%CI：1.232 ~ 5.944；P = 0.032）为影响患者发病3 个月时预后的危险因素。提示LDL-C/HDL-C比值是一项具有临床价值的实验室预测指标，对急性缺血性卒中远期结局有一定预测价值。

关键词: 卒中, 脂蛋白类, LDL, 脂蛋白类, HDL, 高脂血症, 危险因素, 回归分析

Abstract: This paper aims to investigate the relationship between the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and risk factors for acute ischemic stroke, and to investigate the effect of LDL-C/HDL-C on the 3-month outcome of acute ischemic stroke. Based on baseline characteristics and laboratory data on admission, 150 patients with non?cardiac acute ischemic stroke were divided into 2 groups (LDL-C/HDL-C ≤ 3 and LDL-C/HDL-C > 3). The outcome of 3 months after stroke was analyzed, and the risk factors were compared between 2 groups. There was significant difference in history of diabetes, history of coronary artery disease, history of smoking and atherosclerotic lesions between 2 groups (P < 0.05, for all). After using multifactor stepwise Logistic regression analysis, only the LDL-C/HDL-C ratio > 3 (OR = 1.781, 95%CI: 1.343-2.374; P = 0.001) and National Institute of Health Stroke Scale (NIHSS) score on admission (OR = 1.923, 95%CI: 1.232-5.944; P = 0.032) were significantly and independently predictive for 3?month outcome. Therefore, the ratio of LDL-C to HDL-C serves as a positive predictor of the 3-month clinical outcome of acute ischemic stroke.

Key words: Stroke, Lipoproteins, LDL, Lipoproteins, HDL, Hyperlipidemias, Risk factors, Regression analysis