老年急性缺血性脑卒中患者血清中尿酸、总胆红素以及脂蛋白等相关因素的综合性分析

Comprehensive analysis of factors correlated to serum uric acid, bilirubin and lipoprotein in elderly patients with acute ischemic stroke

摘要:

目的  探讨老年急性缺血性脑卒中患者血清中尿酸、总胆红素以及脂蛋白水平与其他因素的变化在急性缺血性脑卒中发生发展中的作用以及相关关系的综合性分析。方法  选取在2014年1月-2015年12月首次住院治疗的老年急性缺血性脑卒中患者114例（脑卒中组）。急性期24h空腹抽血测定其急性期尿酸、总胆红素、三酰甘油、血糖、高密度脂蛋白、低密度脂蛋白、载脂蛋白B（ApoB）、载脂蛋白A1（ApoA1）、总胆固醇等水平，与同期健康体检者90例（对照组）进行比较。结果  急性缺血性脑卒中组体重指数（BMI）、尿酸、三酰甘油、血糖、低密度脂蛋白、ApoB/ApoA1、总胆固醇、收缩压、舒张压明显高于对照组（P <0.01）；病例组总胆红素和高密度脂蛋白低于对照组（P <0.01）；尿酸与BMI、三酰甘油、血糖、低密度脂蛋白、ApoB/ApoA1、舒张压呈显著正相关（P<0.01），尿酸与总胆红素和收缩压呈负相关（P <0.01）；总胆红素与高密度脂蛋白呈正相关（P <0.01），与尿酸、三酰甘油、血糖、低密度脂蛋白、ApoB/ApoA1、总胆固醇、收缩压以及舒张压呈负相关（P <0.01）；低密度脂蛋白与BMI、尿酸、血糖、ApoB/ApoA1、总胆固醇呈正相关（P <0.01），与年龄、三酰甘油、高密度脂蛋白呈负相关（P <0.01）；并且以上结果差异均有统计学意义（P <0.05）。结论  急性脑卒中患者尿酸、总胆红素以及脂蛋白水平的升高都是急性缺血性脑卒中的危险因素，并且这3个独立的危险因素与其他相关因素协同作用，在老年急性缺血性脑卒中发生发展中起到了非常重要的作用。

Abstract:

Objective To explore serum levels of uric acid, bilirubin and lipoprotein in elderly patients with acute ischemic stroke and comprehensively analyze the factors correlated to acute ischemic stroke. Methods A total of 114 acute ischemic stroke patients (AIS group) and 90 matched normal people receiving health examination (control group) between January 2014 and December 2015 were collected. The 24-h fasting serum levels of uric acid, total bilirubin, triglyceride, blood sugar, high density lipoprotein (HDL), low density lipoprotein (LDL), apolipoprotein B (ApoB), apolipoprotein A1 (ApoA1) and total cholesterol were tested in the AIS patients, and compared with those in the control group. Results BMI, triglyceride, uric acid, blood sugar, LDL, ApoB/ApoA1 ratio, total cholesterol, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the AIS group were significantly higher than those of the control group (P < 0.01). Total bilirubin and HDL of the AIS group were lower than those of the control group (P < 0.01). Uric acid was positively correlated with BMI, triglyceride, blood sugar, LDL, ApoB/ApoA1 ratio and DBP (P < 0.01), but negatively correlated with total bilirubin and SBP (P < 0.01). Total bilirubin was in a positive correlation with HDL (P < 0.01), but in negative correlations with uric acid, triglyceride, blood sugar, LDL, ApoB/ApoA1 ratio, total cholesterol, SBP and DBP (P < 0.01). LDL was in positive correlations with BMI, uric acid, blood glucose, ApoB/ApoA1 ratio and total cholesterol (P < 0.01), but in negative correlations with age, triglyceride and HDL (P < 0.01). Conclusions The high levels of uric acid, total bilirubin and lipoprotein are the independent risk factors for acute ischemic stroke in elderly patients. Synergies of the three independent risk factors with other related factors play significant roles in the development of elderly acute brain stroke.