急性腔隙性脑梗死患者慢性肾功能不全与脑微出血的相关性研究

发布时间：2018-06-28 07:29

本文选题：脑微出血 + 慢性肾功能不全　；参考：《医学研究生学报》2017年03期

【摘要】：目的慢性肾疾病(CKD)可增加患者出血性卒中发病风险,而脑微出血(CMBs)正是一种具有出血倾向的小血管病。文中对急性腔隙性脑梗死患者CKD与CMBs的发生及部位进行探讨。方法回顾性连续纳入2014年1月至2016年7月期间在芜湖市第一人民医院神经内科住院治疗的急性(发病7 d内)腔隙性脑梗死患者308例。所有患者行常规磁共振序和梯度回波T2加权扫描,记录患者人口学、实验室检查、临床相关资料[血管学危险因素和美国国立卫生研究院卒中量表(NHISS)评分等]及影像学资料。采用CKD流行病学合作研究公式估算患者的肾小球滤过率(e GFR)。CKD定义为e GFR60 m L/(min·1.73 m2)。结果入组患者平均年龄(65.79±8.67)岁,NHISS评分为3(2~5)分。其中女性130例(42.2%),CKD患者62例(20.1%),CMBs阳性患者116例(37.7%)。将患者按照e GFR水平分成CKD组和正常组。单因素分析结果显示,糖尿病(P=0.014)和CMBs(P=0.001)在组间分布差异有统计学意义。按照部位进行细化,CMBs在CKD组和正常组患者间的分布差异有统计学意义(P0.05)。多因素logistic回归分析结果显示,单纯深部CMBs[OR=7.61,95%CI:4.18~16.55,P=0.001]是CKD发生的独立危险因素,而单纯脑叶混合部位CMBs对CKD的发生无明显作用。结论单纯深部CMBs是急性腔隙性梗死患者发生的独立危险因素;而单纯脑叶和混合部位CMBs与梗死的发生无明显相关性。
[Abstract]:Objective chronic renal disease (CKD) can increase the risk of hemorrhagic stroke, and cerebral microhaemorrhage (CMBs) is a small vascular disease with hemorrhagic tendency. The occurrence and location of CKD and CMBs in patients with acute lacunar cerebral infarction were discussed in this paper. The methods were retrospectively included in the first people of Wuhu from January 2014 to July 2016. Acute (7 d) lacunar infarction patients were hospitalized in hospital neurology in 308 cases. All patients were treated with conventional magnetic resonance sequence and gradient echo T2 weighted scan, recording the patient's demography, laboratory examination, clinical related data [vascular risk factors and the National Health Research Institute's Stroke Scale (NHISS) score, etc.] and imaging information. Estimate the glomerular filtration rate (E GFR).CKD of the patients was defined as e GFR60 m L/ (min 1.73 m2). The average age of the patients was (65.79 + 8.67) years and NHISS score was 3 (2~5). Among them, 130 cases (42.2%), 62 patients (20.1%), 116 patients (37.7%). The results of single factor analysis showed that the distribution of diabetes (P=0.014) and CMBs (P=0.001) were significantly different between groups. The distribution of CMBs between the CKD group and the normal group was statistically significant (P0.05). The results of multiple factor Logistic regression analysis showed that CMBs was only deep CMBs[OR=7.61,95%CI. 4.18~16.55, P=0.001] is an independent risk factor for the occurrence of CKD, while pure cerebral lobar mixed site CMBs has no obvious effect on the occurrence of CKD. Conclusion pure deep CMBs is an independent risk factor for acute lacunar infarction, while pure cerebral lobe and mixed site CMBs have no significant correlation with the onset of infarction.
【作者单位】：芜湖市第一人民医院神经内科;南京军区南京总医院神经内科;
【分类号】：R743.33;R692

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