总胆固醇/高密度脂蛋白胆固醇比值与缺血性卒中复发关系研究 Correlation between Total Cholesterol / High Density Lipoprotein Cholesterol Ratio and Recurrent Stroke in Patients with Acute Ischemic Stroke

【摘要】 目的 探讨急性缺血性卒中90 d内复发与TC/HDL-C比值的关系。 方法 利用急性缺血性卒中患者氧化应激水平临床观察研究（Study on Oxidative Stress in Patients with Acute Ischemic Stroke，SOS-Stroke）数据库的3605例患者作为研究对象，采用多因素Logistic回归分析急性缺血性卒中患者90 d卒中复发的影响因素。 结果 该研究人群中有231例（6.40%）患者90 d卒中复发，多因素Logistics回归结果显示：年龄（OR1.02，95%CI 1.00～1.03，P=0.011）、糖尿病史（OR 1.44，95%CI 1.00～2.07，P=0.048）是卒中复发的危险因素，住院期间服用降脂药物（OR 0.60，95%CI 0.40～0.90，P=0.012）则是卒中复发的保护因素，急性缺血性卒中患者中TC/HDL-C比值不是卒中复发的预测因素。 结论 TC/HDL-C比值不能预测急性缺血性卒中90 d内复发的风险。 【Abstract】 Objective To investigate the correlation between TC/HDL-C ratio and recurrent stroke within 90 days after onset in patients with acute ischemic stroke (AIS). Methods The data of 3605 patients from the Study on Oxidative Stress in Patients with Acute Ischemic Stroke (SOS-Stroke) were selected. Multivariate logistic regression analysis was used to analyze the influence factors for recurrent stroke within 90 days after onset in patients with AIS. Results Recurrent stroke within 90 days occurred in 231 patients (6.40%). Logistic regression analysis showed that age (OR 1.02, 95%CI 1.00-1.03, P=0.011), history of diabetes (OR 1.44, 95%CI 1.00-2.07, P=0.048) were the risk factors of recurrent stroke, and taking lipid-lowering drugs during hospitalization (OR 0.60, 95%CI 0.40-0.90, P=0.012) was the protection factor of recurrent stroke. Conclusions TC/HDL-C ratio can’t predict the risk of recurrent stroke within 90 days after onset in AIS patients

中国脑血管病临床管理指南（第2版）（节选）——第2章 卒中组织化管理推荐意见 Chinese Stroke Association Guidelines for Clinical Management of Cerebrovascular Diseases (Second Edition)(Excerpt)—Chapter Two Stroke Organized Management

卒中是我国成人致死、致残的首位病因，给患者及社会发展带来了沉重负担。组织化管理方法能够一定程度上提升卒中医疗质量,但医疗机构后勤服务支撑能力的异质性为卒中组织化管理的效果带来不确定影响。为进一步完善卒中组织化管理模式，提升卒中治疗的科学性及系统性，本指南就院前急救系统及卒中急诊的组织化管理、急诊多学科协作团队的管理、绿色通道的持续质量改进、卒中单元及卒中门诊的组织化管理、卒中中心的区域协同网络建设、医疗质量评估与改进等多个方面，形成了推荐意见。 Abstract: Stroke is a leading cause of mortality and disability among adults in China, imposing a substantial burden on both patients and societal development. The organizational management method can improve the medical quality of stroke to some extent. However, the heterogeneity of logistics support capacity in medical institutions brings uncertain effects on the effectiveness of stroke organizational management. In order to improve the organized management model of stroke and enhance the scientific and systematic nature of stroke treatment, this guidelines has formed recommendations on the coordination of pre-hospital emergency systems and stroke care facilities, multidisciplinary collaboration within emergency settings, the continuous quality improvement of green channels, the organizational management of stroke units and stroke clinics, development of regional stroke center networks, as well as medical quality assessment and enhancement initiatives