Objective To study the blood lipid-associated gender difference in patients with large artery atherosclerosis (LAA) ischemic stroke. Methods A total of 4189 first-ever ischemic stroke patients, selected from China National Stroke Registry, were divded into LA A ischemic stroke group(n=1919), small vessel occlusion(SVO) group(n=716),and non-LAA&SVO group(n = 1554) according to the TOAST etiological classification. Correlation of serum TG,TC,HDL-C and LDL-C levels with LAA was analyzed. Results The serum TC, HDL-C and LDL-C levels were significantly higher in female LAA ischemic stroke patients than in male LAA ischemic stroke pa tients(P<0. 01). Logistic regression analysis showed that the serum TC,HDL-C and LDL-C lev els were correlated with the occurrence of LAA. The serum TG level was closely correlated with LAA in male patients. Conclusion Elevated serum TC and LDL-C levels are closely correlated with LAA in ischemic stroke patients. There is a gender difference when serum TG level is used as a predictor for the risk of LAA. Besides serum TC and LDL-C levels, serum TG level should thus be considered in male LAA ischemic stroke patients.%目的 研究大动脉粥样硬化性(LAA)脑梗死相关血脂指标的性别差异.方法 选择中国国家卒中登记数据库中4189例首发脑梗死患者,依据TOAST病因学分型分为LAA组1919例、小血管闭塞(SVO)组716例和非LAA&SVO组1554例.分析TG、TC、HDL-C、LDL-C水平与LAA的相关性.结果 3组除TG外,女性TC、HDL-C、LDL-C水平均高于男性(P＜0.01).LAA组vs非LAA组,LAA组vs非LAA&SVO组的2个logistic回归模型分析均显示:TC、LDL-C水平与LAA发生相关.男性患者TG水平与LAA的相关性有显著意义,TG每升高1个四分位数区间,LAA组较非LAA组、非LAA&SVO组发生的可能性分别增加8.6％和15.0％.结论 相较于其他缺血性脑卒中亚型,TC、LDL-C增高与LAA的发生密切相关；TG在预测颅内外LAA风险时,存在性别差异,对于男性除常规关注TC、LDL-C外,还需将TG考虑在内.
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