中国卒中杂志2018，Vol.13Issue(5)：444-449,6.DOI:10.3969/j.issn.1673-5765.2018.05.007
不同肾功能水平的急性缺血性卒中患者血浆氧化低密度脂蛋白水平对患者预后的影响
Effect of Plasma Oxidized Low Density Lipoprotein on Prognosis in Acute Ischemic Stroke Patients with Different Levels of Renal Function
摘要
Abstract
Objective To investigate the correlation between functional prognosis and plasma oxidized low-density lipoprotein (oxLDL) in acute ischemic stroke (AIS) patients with different levels of renal function. Methods All subjects were recruited from the Study of Oxidative Stress in Patients With Acute Ischemic Stroke (SOS-Stroke). Plasma level of ox-LDL was measured by enzyme-linked immuno sorbent assay (ELISA). Patients were stratified by the calculated glomerular filtration rate, and followed up at 1 year after stroke onset to assess the modified Rankin Scale (mRS) score. Analysis of the relationship between oxLDL and poor prognosis (modified Rankin scale ≥3 points) in patients with different levels of renal function were performed. Results A total of 3284 patients were enrolled in this study, of whom 877 (26.71%) had poor functional outcomes. After grouping according to renal function, there were 1241 cases of normal control, 924 cases of mild abnormality, and 242 cases of moderate-severe abnormality. Patients of poor prognosis in all groups were respectively 344 (21.70%) cases of normal group, 371 (28.65%) cases of mild abnormal group, and 162 cases (40.10%) of moderate-severe abnormal group. The plasma level of oxLDL had a significant effect on 1-year mRS score in the patients with normal and mild damage renal function: in normal renal function group, the mRS score increased by 0.12 points for each standard deviation increase in oxLDL [OR 0.12, 95%CI 0.05-0.19, P=0.0009], and the risk of poor prognosis increased by 20% (OR 1.20, 95%CI 1.02-1.40, P=0.0271); in mild renal impairment group, the mRS score increased by 0.16 points for each standard deviation increase in oxLDL. (OR 0.16, 95%CI 0.07-0.25,P=0.0007), and the risk of poor prognosis increased by 21% (OR 1.21, 95%CI 1.03-1.41, P=0.0190); however, in moderate-severe renal impairment group, plasma oxLDL levels did not significantly affect the mRS score. Conclusion The increased of plasma oxLDL levels in AIS patients with normal renal function and mild renal impairment are associated with the poor prognosis within 1 year.关键词
急性缺血性卒中/氧化低密度脂蛋白/肾功能/功能预后Key words
Acute ischemic stroke/Oxidized low-density lipoprotein/Renal function/Functional prognosis引用本文复制引用
任艳辉,孙原,吕微,孟霞,王翠兰,杨斌,石秋艳..不同肾功能水平的急性缺血性卒中患者血浆氧化低密度脂蛋白水平对患者预后的影响[J].中国卒中杂志,2018,13(5):444-449,6.基金项目
国家自然科学基金资助课题(81473071) （81473071）
