Serum triglyceride level is an important predictor of early prognosis in patients with acute ischemic stroke
Serum triglyceride level is an important predictor of early prognosis in patients with acute ischemic stroke
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DOI：
10.1016/j.jns.2012.04.018
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发表时间：
2012-08-15
影响因子：
4.4
通讯作者：
Cho, Ki-Hyun
中科院分区：
文献类型：
--
作者：
Choi, Kang-Ho;Park, Man-Seok;Cho, Ki-Hyun
背景：最近的一些研究表明，急性缺血性卒中（AIS）后的不良预后与血清甘油三酯（TG）水平降低密切相关，而不是高甘油三酯血症。然而，高甘油三酯血症已被证明是冠状动脉疾病患者预后不良的独立预测因素。本研究试图评估血清 TG 水平与 AIS 早期预后之间的关联。方法：我们连续纳入了 736 名 AIS 患者。根据国家胆固醇教育计划 (NCEP) 的指南，根据 TG 水平将患者分为 5 组。我们将早期神经功能恶化 (END) 定义为 NIH 卒中量表 (NIHSS) 评分恶化 4 分或以上，将早期临床改善 (ECI) 定义为症状出现后一周内 NIHSS 评分降低 4 分。我们比较了患有 END、ECI 以及既没有 END 又没有 ECI 的患者。结果：与正常组相比，hyperTG 和 lowTG 组的 END 风险显着更高。与正常组相比，低TG组、边缘组和高TG组的ECI百分比显着降低。对于 END，与低正常组（50 至 100 mg/dl）相比，低 TG、边缘性和高 TG 组的多变量调整比值比显着较高。结论：在 AIS 中，TG 与不良结局呈非线性 J 形关联，与良好结局呈反向 J 形关联。这项研究表明，hyperTG 和 lowTG 都可能是 AIS 早期预后不良的危险因素。 (C) 2012 Elsevier B.V. 保留所有权利。
Background: Some recent studies have shown that poor outcomes after acute ischemic stroke (AIS) were closely related to lower serum triglyceride (TG) levels, not hypertriglyceridemia. However, hypertriglyceridemia has been shown to be an independent predictor for poor outcome in patients with coronary artery disease. This study attempted to evaluate the association between serum TG levels and early prognosis of AIS.Methods: We enrolled 736 consecutive patients with AIS. Based on the TG level, patients were divided into 5 groups based on the guidelines of the National Cholesterol Education Program (NCEP). We defined early neurological deterioration (END) as a 4-point or greater deterioration of the NIH stroke scale (NIHSS) score and early clinical improvement (ECI) as a 4-point reduction of NIHSS within a week after symptom onset. We compared patients with END, ECI, and neither END nor ECI.Results: The risk of END was significantly higher in the hyperTG and hypoTG groups compared with the normal group. The percentages of ECI were significantly lower in the hypoTG, borderline, and hyperTG groups compared with the normal group. For END, the multivariable adjusted odds ratios were significantly higher in the hypoTG, borderline, and hyperTG groups compared with the low normal group (50 to 100 mg/dl).Conclusions: TG had a nonlinear, J-shaped association with poor outcome and a reverse J-shaped association with good outcome in AIS. This study suggests that both hyperTG and hypoTG can be risk factors for poor early outcome in AIS. (C) 2012 Elsevier B.V. All rights reserved.