胆固醇、高密度脂蛋白和葡萄糖指数与缺血性卒中或短暂性脑缺血发作患者卒中复发的关联：一项基于全国注册登记的队列研究

doi:10.3969/j.issn.1006-7795.2026.01.005

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (1): 37-42.doi: 10.3969/j.issn.1006-7795.2026.01.005

胆固醇、高密度脂蛋白和葡萄糖指数与缺血性卒中或短暂性脑缺血发作患者卒中复发的关联：一项基于全国注册登记的队列研究

董立平¹，李欣亚^2,3,4,5，荆京^2,3，夏雪^2,3,4,5，高萌^2,3,4,5，田雪^2,3,4,5，张怡君^2,3,4,5，王安心^2,3,4,5*

1．北京市大兴区人民医院神经内科，北京 102600；2．首都医科大学附属北京天坛医院神经病学中心，北京 100070；3．首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心，北京 100070；4．首都医科大学临床流行病与临床试验学系，北京 100070；5．首都医科大学附属北京天坛医院北京市神经外科研究所流行病学研究室，北京 100070

收稿日期:2025-10-20 修回日期:2025-11-04 出版日期:2026-02-21 发布日期:2026-02-02
通讯作者: 王安心 E-mail:wanganxin@bjtth.org
基金资助:
国家重点研发计划项目（2022YFC3600600）。

Association of cholesterol, high-density lipoprotein, and glucose index with stroke recurrence in patients with ischemic stroke or transient ischemic attack: a nationwide registry-based cohort study

Dong Liping1, Li Xinya2,3,4,5, Jing Jing2,3,4,5, Xia Xue2,3,4,5, Gao Meng2,3,4,5, Tian Xue2,3,4,5, Zhang Yijun2,3,4,5, Wang Anxin2,3,4,5*

1.Department of Neurology, Beijing Daxing District People’s Hospital, Beijing 102600, China；2.Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China；3.National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China；4.Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing 100070, China；5.Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2025-10-20 Revised:2025-11-04 Online:2026-02-21 Published:2026-02-02
Supported by:
This study was supported by National Key Research and Development Program of China (2022YFC3600600).

摘要/Abstract

摘要： 目的系统分析胆固醇、高密度脂蛋白和葡萄糖（cholesterol，high-density lipoprotein，and fasting blood glucose，CHG）指数与缺血性卒中或短暂性脑缺血发作（transient ischemic attack，TIA）患者卒中复发及其他不良结局的关联。方法本研究数据来源于第三次中国国家卒中登记，纳入发病7 d内的缺血性卒中或TIA患者。暴露因素为基线CHG指数。根据CHG指数的四分位数将研究人群分组，记为Q1、Q2、Q3和Q4。主要结局指标为1年内卒中复发。采用Cox比例风险模型分析CHG指数与结局的关系，计算风险比（hazard ratio，HR）和95%置信区间（confidence interval，CI）。共建立四个模型。结果共11 946例患者纳入分析。本研究中患者年龄中位数为62（54，70）岁，其中，男性8 126例（68.02%）。与Q1组相比，Q2、Q3和Q4组均与更高的卒中复发风险相关，模型4中HR（95% CI）分别为1.38（1.08~1.77）、1.46（1.15~1.87）和1.44（1.12~1.86）。当CHG指数作为连续变量时，关联依然显著。结论 CHG指数与缺血性卒中或TIA患者卒中复发呈正相关。在临床实践中，建议更加关注血脂和血糖水平异常的患者，强化二级预防措施的实施和依从，以减少卒中复发。

关键词: 胆固醇, 高密度脂蛋白, 葡萄糖, 缺血性卒中, 短暂性脑缺血发作, 卒中复发

Abstract: Objective To systematically analyze the associations between the cholesterol, high-density lipoprotein, and fasting blood glucose (CHG) index and stroke recurrence as well as other adverse outcomes in patients with ischemic stroke or transient ischemic attack (TIA).Methods The data source for this study was the China National Stroke Registry-Ⅲ (CNSR-Ⅲ）. Patients with ischemic stroke or TIA within 7 d of onset were included. The exposure factor was the baseline CHG index. The study population was grouped according to the quartiles of the CHG index, designated as Q1, Q2, Q3, and Q4. The primary outcome measure was stroke recurrence within 1 year. The Cox proportional hazards model was employed to analyze the relationship between the CHG index and the outcomes, and the hazard ratio (HR) and 95% confidence intervals (CI) were calculated. A total of four models were constructed.Results A total of 11 946 patients were included in the analysis. The median (interquartile range) age of the patients was 62 (54, 70) years, and 8 126 (68.02%) patients were male. Compared with the Q1 group, the Q2, Q3, and Q4 groups were all associated with a higher risk of stroke recurrence. In Model 4, the HR (95% CI) were 1.38 (1.08-1.77), 1.46 (1.15-1.87), and 1.44 (1.12-1.86), respectively. When the CHG index was treated as a continuous variable, the association remained statistically significant.Conclusion The CHG index is positively associated with stroke recurrence in patients with ischemic stroke or TIA. In clinical practice, it is advisable to pay more attention to patients with abnormal lipid and blood glucose levels and strengthen the implementation and adherence to secondary prevention measures to reduce stroke recurrence.

Key words: cholesterol, high-density lipoprotein, glucose, ischemic stroke, transient ischemic attack, stroke recurrence

中图分类号:

R743

董立平, 李欣亚, 荆京, 夏雪, 高萌, 田雪, 张怡君, 王安心. 胆固醇、高密度脂蛋白和葡萄糖指数与缺血性卒中或短暂性脑缺血发作患者卒中复发的关联：一项基于全国注册登记的队列研究[J]. 首都医科大学学报, 2026, 47(1): 37-42.

Dong Liping, Li Xinya, Jing Jing, Xia Xue, Gao Meng, Tian Xue, Zhang Yijun, Wang Anxin. Association of cholesterol, high-density lipoprotein, and glucose index with stroke recurrence in patients with ischemic stroke or transient ischemic attack: a nationwide registry-based cohort study[J]. Journal of Capital Medical University, 2026, 47(1): 37-42.

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胆固醇、高密度脂蛋白和葡萄糖指数与缺血性卒中或短暂性脑缺血发作患者卒中复发的关联：一项基于全国注册登记的队列研究

Association of cholesterol, high-density lipoprotein, and glucose index with stroke recurrence in patients with ischemic stroke or transient ischemic attack: a nationwide registry-based cohort study

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