【摘要】 目的 探讨残余胆固醇(RC)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)对急性脑梗死(ACI)患者静脉溶栓预后的影响。方法 收集2023年1月至2025年1月在保定市第一中心医院接受替奈普酶(TNK-tPA)静脉溶栓的451例ACI患者的临床资料,依据90 d改良Rankin量表(mRS)评分分为两组:预后良好组(mRS≤2分)和预后不良组(mRS> 2分)。采用SPSS 27.0统计软件进行分析,构建Logistic回归模型,探究RC、LDL-C/HDL-C与ACI静脉溶栓预后的相关性。用受试者工作特征(ROC)曲线分析RC、LDL-C/HDL-C预测ACI静脉溶栓预后风险。结果 多因素Logistic回归分析:溶栓前NIHSS评分、RC、LDL-C/HDL-C与ACI静脉溶栓90 d的预后不良独立相关(溶栓前NIHSS评分:OR=1.790,95%CI 1.572～2.038;RC:OR=3.461,95%CI 1.383～8.659;LDL-C/HDL-C:OR=1.679,95%CI 1.176～2.398,P<0.05)。ROC分析显示,RC联合LDL-C/HDL-C预测ACI静脉溶栓预后曲线下面积为0.646,高于RC、LDL-C/HDL-C单独预测的0.602、0.624 (P <0.05),有较好的预测价值。结论高RC、LDL-C/HDL-C与ACI静脉溶栓预后不良独立相关;联合RC与LDL-C/HDL-C预测ACI静脉溶栓预后的价值较高。更多还原

【Abstract】 Objective To investigate the impact of residual cholesterol(RC) and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol(LDL-C/HDL-C) on the outcomes of intravenous thrombolysis in patients with acute ischemic stroke(ACI).Methods Data from 451 patients with acute ischemic stroke(ACI) who received tranexamic acid(TNK-tPA) intravenous thrombolysis at the Baoding First Central Hospital from January 2023to January 2025 were collected and analyzed.Patients were divided into two groups based on their 90-morbid Rankin scale(mRS) scores:the good prognosis group(mRS≤2 score) and the poor prognosis group(mRS> 2 score).Statistical analysis was performed using SPSS 27.0 software,and a Logistic regression model was constructed to investigate the correlation between RC,LDL-C/HDL-C,and the prognosis of ACI intravenous thrombolysis.ROC curve analysis was employed to evaluate the predictive value of RC and LDL-C/HDL-C in assessing the risk of ACI intravenous thrombolysis prognosis.Results Logistic regression analysis of prognostic factors revealed independent correlations between NIHSS scores,regional contracture(RC),LDL-C/HDL-C levels,and 90-day venous thrombolysis adverse outcomes.Pre-treatment NIHSS scores showed an odds ratio(OR) of 1.790(95% CI 1.572-2.038),RC demonstrated an OR of 3.461(95% CI 1.383-8.659),and LDL-C/HDL-C exhibited an OR of 1.679(95% CI 1.176-2.398,P <0.05).ROC analysis indicated that the combined RC and LDL-C/HDL-C predictor achieved an area under the curve(AUC)of 0.646 for venous thrombolysis prognosis,significantly outperforming individual predictors(AUC:0.602 for RC,0.624for LDL-C/HDL-C,P <0.05),demonstrating strong predictive value.Conclusion High levels of RC,LDL-C/HDL-C,and ACI are independently associated with poor venous thrombolysis outcomes.The combination of RC and LDL-C/HDL-C demonstrates greater predictive value for venous thrombolysis prognosis in ACI patients.更多还原