血清非传统脂质参数、TyG、MHR对分水岭脑梗死的诊疗价值

许娟娟; 李理; 马博; 骆嵩; 潘露; 郝佳妮; 刘东亮

血清非传统脂质参数、TyG、MHR对分水岭脑梗死的诊疗价值

The diagnostic and therapeutic value of serum non-traditional lipid parameters, TyG and MHR in watershed stroke

摘要

摘要:
目的： 探讨血清非传统脂质参数包括血浆致动脉粥样硬化指数（AIP）、残余胆固醇（RC）、致动脉粥样硬化系数（AC）、非高密度脂蛋白胆固醇（non–HDL–c）及三酰甘油葡萄糖指数（TyG）、单核细胞计数（MON）与高密度脂蛋白胆固醇（HDL–c）比值（MHR）在分水岭脑梗死（CWI）病人中的水平变化，评估其对CWI的辅助诊疗价值。
方法： 回顾性分析94例诊断明确的CWI病人资料，计算非传统脂质参数以及TyG、MHR。根据病人入院第1天的美国国立卫生研究院卒中量表（NIHSS）评分分为轻度组（NIHSS≤3分）、中度组（NIHSS 4 ~ 15分）、重度组（NIHSS≥16分）；根据病人发病后30 d的改良Rankin量表(mRS)评分分为短期预后良好组（mRS评分≤2分）和预后不良组（mRS评分＞ 2分）。轻度组41例，中–重度组共53例；预后良好组74例，预后不良组20例。采用logistic回归分析、Spearman相关性分析等探讨各组以上指标与疾病严重程度、短期预后的相关性。
结果： 血糖（GLU）、non–HDL–c和MHR越高，出现中–重度脑梗死的风险越高（P ＜ 0.05 ~ P ＜ 0.01）；MHR、TyG越高，发生预后不良的可能性越高（P ＜ 0.01）。AC、RC、MHR、GLU、MON和TyG和病人入院时NIHSS评分呈正相关关系（P ＜ 0.05 ~ P ＜ 0.01）；GLU、MON、AIP、AC、RC、MHR、TyG与发病后30 dmRS评分呈现正相关关系，HDL–c与发病后30 dmRS评分呈现负相关关系（P ＜ 0.05 ~ P ＜ 0.01）。
结论： 清非传统脂质参数、TyG指数及MHR与CWI的严重程度及短期预后密切相关。GLU、non–HDL–c与MHR是评估病情严重程度的独立影响因素；MHR与TyG是预测短期预后不良的独立指标。

Abstract:
Objective To investigate the changes of serum non-traditional lipid parametersincluding plasma atherogenic index (AIP), residual cholesterol (RC), atherogenic coefficient (AC), non high density lipoprotein cholesterol (non HDL-c), triacylglycerol glucose index (TyG), monocyte count (MON) and high density lipoprotein cholesterol (HDL-c) ratio (MHR) in patients with watershed cerebral infarction (CWI), and evaluate their auxiliary diagnostic and therapeutic value for CWI.
Methods A retrospective analysis was conducted on the data of 94 patients with diagnosed CWI, and the non-traditional lipid parameters, TyG and MHR were calculated. According to the National Institutes of Health Stroke Scale (NIHSS) score on the first day of admission, the patients were divided into the mild group (NIHSS ≤ 3 points), moderate group (NIHSS 4-15 points) and severe group (NIHSS ≥ 16 points); According to the modified Rankin Scale (mRS) score after 30 days of onset, the patients were divided into the short-term good prognosis group (mRS score ≤ 2) and a poor prognosis group (mRS score ＞ 2). There were 41 cases in the mild group and 53 cases in the moderate to severe group, and there were 74 cases in the good prognosis group and 20 cases in the poor prognosis group. The logistic regression analysis and Spearman correlation analysis were used to explore the correlations between the above indicators in each group and severity of the disease and short-term prognosis.
Results The higher the blood glucose (GLU), non-HDL-c and MHR, the higher the risk of moderate to severe cerebral infarction (P ＜ 0.05 to P ＜ 0.01). The higher the MHR and TyG, the higher the possibility of poor prognosis (P ＜ 0.01). The AC, RC, MHR, GLU, MON and TyG were positively correlated with the NIHSS score of the patients at admission (P ＜ 0.05 to P ＜ 0.01). The GLU, MON, AIP, AC, RC, MHR and TyG were positively correlated with the Mrs score after 30 days of onset of the disease, while the HDL-c was negatively correlated with the Mrs score 30 days after the onset of the disease (P ＜ 0.05 to P ＜ 0.01).
Conclusions Serum non-traditional lipid parameters, TyG index and MHR are closely related to the severity and short-term prognosis. The CWI. GLU, non-HDL-c and MHR are independent influencing factors for evaluating the severity of the disease. MHR and TyG are independent indicators for predicting poor short-term prognosis.

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