뇌졸중 발생 후 시간경과에 따른 혈중 지질치 변화와 허혈성 뇌졸중 아형별 혈중 지질치의 임상적 의의

Abstract

Background : Serum lipid level as a risk factor of stroke has not been extensively investigated. The aims of this study are to examine the changes of serum lipid profiles prospectively after acute stroke and to elucidate the role of serum lipids as a risk factor in different subtypes of ischemic stroke. Methods : Cases (N=106) of acute stroke were recruited from the Hallym Stroke Center from January of 1996 to June of 1998. Age and sex matched healthy control subjects (N=137) were recruited at the Hallym Helath Care Center between May of 1996 and May of 1998. The serum levels of triglyceride (TG), total cholesterol (T-chol), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were analyzed within 48 hours, at one week and at three months after stroke onset. Results : The stroke subtypes were; 54 had large artery atherosclerosis and 52 had small vessel occlusive diseases. T-chol and LDL-L were decreased at 1 week after stroke whereas HDL-C was not. The level of LDL-C within 48 hours was higher and the level of HDL-C within 48 hours and at 1 week after stroke were lower in patients than in healthy controls while there was no difference in the levels of T-chol and TG between the patients and controls. When the levels of LDL-C and HDL-C were divided into quintiles, the differences of the first and the fifth quintiles were statistically significant between the patients and controls. However, no variables in lipid profile acted as independent stroke risk factors in multiple regression model. Conclusions : In this study, “acute lowering effect of lipid”was demonstrated in the patients with acute stroke while serum lipid variables were not found to be significant risk factors for ischemic stroke. Korean Journal of Stroke 2000;2(1): 28~34