| Background-With the aging of the population in China,the incidence of stroke is increasing year by year,and cerebral infarction and intracerebral hemorrhage accounted for the vast majority.Comparing with cerebral infarction,intracerebral hemorrhage has acute onset,severe illness and high mortality.Considered as a risk factor for cerebral infarction,low density lipoprotein cholesterol is reduced clinically in patients with cerebral infarction or risk factors,and the lower the better.However,some studies have suggested that too low LDL-C can increase the risk of cerebral hemorrhage,especially for patients with high blood pressure history,so LDL-C should not be reduced too low.There is still debate about whether LDL-C can increase the risk of cerebral hemorrhage.Method-The 18-80 years old hypertensive patients and hypertensive patients with cerebral infarction or intracerebral hemorrhage of Qilu hospital of Shandong University were collected from 2007-2016,eliminating patients with smoking,diabetes,coronary heart disease,blood disease,atrial fibrillation,hyperthyroidism,arteriovenous malformations,aneurysms and other risk factors of cerebral infarction or cerebral hemorrhage.The patients’ gender,age,oral antihypertensive drugs situation and the difference of low-density lipoprotein cholesterol between cerebral infarction group and intracerebral hemorrhage group were analyzed statistically.Result-Of 1261 patients,344 were hypertensive patients(average age 55.4 years old),538 were cerebral infarctions(average age 59.4 years old)and 379 were intracerebral hemorrhages(average age 54.2 years old).In patients with cerebral infarctions and intracerebral hemorrhage,395 did not take antihypertensive drugs or irregular medication(40%),but only 282were treated with drugs(30.8%).But in hypertensive patients,223 were treated with drugs(64.8%).The history of hypertension and hypertension grade had no significant difference between cerebral infraction and intracerebral hemorrhage patients with hypertensive patients,but the age of patients with cerebral infarction was significantly higher than that of intracerebral hemorrhage patients(P<0.001)and the number of patients not taking medicine or not regularly taking antihypertensive drugs in intracerebral hemorrhage group and cerebral infarction group were more than that in hypertensive group.There were significant differences in LDL-C between cerebral infarction group(3.12mmol/L,P<0.001)and intracerebral hemorrhage group(2.68mmol/L,P<0.001)with hypertensive patients,and TC were also significantly different.In both male and female patients,LDL-C and TC in patients with intracerebral hemorrhage were significantly different from those with hypertension.Only in 50-59 years old and 70-80 years old age group,there were significant differences in LDL-C between intracerebral hemorrhage and hypertensive patients.And TC had differences in 50-59 years old,60-69 years old and 70-80 years old age group.In patients with 5-10 years and 10-20 years hypertension history group,LDL-C and TC in intracerebral hemorrhage patients were significantly lower than that of hypertensive patients.There was no significant difference in the level of cholesterol in patients with cerebral hemorrhage and hypertension.However,only in taking regular medication patients,LDL-C(P=0.020)and TC(P=0.013)levels had significant difference between intracerebral hemorrhage and hypertensive patients.With the decrease of LDL-C and TC value,the proportion of patients with cerebral hemorrhage increased significantly,while the proportion of cerebral infarction decreased.In LDL-C<2.59mmol/L and TC<2.86mmol/L patients,the proportion of intracerebral hemorrhage patients was significantly higher than that in not grouped patients;while in LDL-C>3.37mmol/L and TC>5.98mmol/L patients,the proportion lower.Conclusion-LDL-C and TC have different effects on different types of stroke.High level LDL-C and TC increase the risk of cerebral infarction,and low level LDL-C and TC are risk factors for cerebral hemorrhage.In both men and women,especially in older patients,patients with hypertension less than 20 years and regularly taking drugs patients,low level LDL-C and TC increased the risk of intracerebral hemorrhage.But for patients with hypertension,it still need to antihypertensive treatment.And the lower the level LDL-C,the greater the risk of cerebral hemorrhage. |
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