维持性血液透析并发脑卒中的危险因素探讨

发布时间：2018-10-22 12:24

【摘要】：目的探讨维持性血液透析(MHD)并发脑卒中的相关危险因素。方法回顾性分析40例MHD并发脑卒中患者(卒中组)的临床资料,根据CT或者MRI分为缺血组(15例)与出血组(25例),50例同期单纯MHD患者(非卒中组)作为对照组。结果卒中组较非卒中组原发病为糖尿病肾病发生率、透前血压及平均动脉压、低密度脂蛋白(LDL)、超敏C-反应蛋白(hs-CRP)均偏高;从亚组分析看,缺血性卒中组尿酸(UA)较高,出血性卒中组血小板(PLT)较低(P0.05)。Logistic回归分析显示原发病为糖尿病、透前平均动脉压、超敏C-反应蛋白(hs-CRP)为血液透析发生脑卒中的危险因素;尿酸为血液透析发生缺血性卒中的危险因素;血小板为血液透析发生出血性卒中的保护性因素。结论 MHD患者发生脑卒中与糖尿病肾病、高血压、尿酸及血小板、hs-CRP水平相关。
[Abstract]:Objective to investigate the risk factors associated with stroke in maintenance hemodialysis (MHD) patients. Methods the clinical data of 40 patients with MHD complicated with stroke (stroke group) were retrospectively analyzed. According to CT or MRI, they were divided into ischemic group (15 cases) and hemorrhage group (25 cases), and 50 cases of MHD alone (non-stroke group) as control group. Results the incidence of diabetic nephropathy in stroke group was higher than that in non-stroke group, the blood pressure and mean arterial pressure were higher in stroke group than in non-stroke group, and low density lipoprotein (LDL) (LDL), hypersensitive C-reactive protein (hs-CRP) was higher in stroke group than in non-stroke group, the (UA) of uric acid in ischemic stroke group was higher than that in ischemic stroke group. The platelet (PLT) was lower in the hemorrhagic stroke group (P0.05). Logistic regression analysis showed that the primary disease was diabetes, mean arterial pressure before dialysis, hs-CRP was the risk factor of stroke in hemodialysis. Uric acid was the risk factor for ischemic stroke in hemodialysis and platelet was the protective factor for hemorrhagic stroke in hemodialysis. Conclusion Stroke in MHD patients is associated with diabetic nephropathy, hypertension, uric acid, platelet and hs-CRP levels.
【作者单位】：华中科技大学同济医学院附属武汉市中心医院肾内科;
【分类号】：R459.5;R743.3

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