血尿素氮/肌酐比值和尿比重与急性脑梗死静脉溶栓预后的相关性研究

目的：测定急性脑梗死患者溶栓前血尿素氮/肌酐( BUN/Cr)比值及尿比重,探讨其与静脉溶栓预后的关系。方法选取2014年12月—2015年9月急性脑梗死静脉溶栓患者121例,根据静脉溶栓治疗后第90日改良Rankin量表(mRS)评分分为预后良好组(mRS评分：0~2)72例及预后不良组(mRS评分：3~6)49例。以BUN/Cr≥15和尿比重>1.010同时作为脱水指标,分析其与临床预后的关系。结果经单因素分析显示与预后不良相关的因素有：入院时美国国立卫生院脑卒中量表评分、尿素氮、尿比重、BUN/Cr比值、脱水状态、房颤病史、甘油三酯、血糖、同型半胱氨酸、总蛋白水平、白蛋白水平(P<0．05,P<0．01)。多因素Logistic回归分析提示脱水状态、房颤病史和白蛋白水平均是预后不良的独立危险因素(P<0．01)。结论本研究显示以BUN/Cr≥15和尿比重>1.010作为脱水状态指标可预测急性脑梗死静脉溶栓临床预后,尽快纠正脱水状态可能会改变其远期预后。

Correlation between Blood Ureanitrogen/Creatinine Ratio and Urine Specific Gravity and Prognosis of Patients with Acute Cerebral Infarction after Intravenous Thrombolysis

Objective To detect blood urea nitrogen/creatinine ( BUN/Cr ) ratio and urine specific gravity ( USG) and to investigate the correlations between BUN/Cr and USG and prognosis of patients with acute cerebral infarc-tion ( ACI) after intravenous thrombolysis. Methods A total of 121 ACI patients after intravenous thrombolysis during December 2014 and September 2015 were divided into good outcome group(0-2 of mRS score, n=72)and poor outcome group (3-6mRS of score, n=49) according to modified Rankin scale (mRS) score on the 90thd after intravenous throm-bolysis. The BUN/Cr ratio equal or over 15 and USG value over 1. 010 were used as markers of relative dehydration, and the relationships between BUN/Cr and USG and prognosis were analyzed. Results The single factor analysis showed that related factors of unfavourable prognosis were the National Institutes of Health Stroke Scale ( NIHSS) score, urea ni-trogen, USG, BUN/Cr ratio, dehydration condition, fibrillation atrial history and levels of triglyceride, blood glucose, homocysteic acid, total protein level and albumin (P<0. 05, P<0. 01). The multivariate logistic regression analysis showed that markers of relative dehydration, and fibrillation atrial history and albumin level were independent risk factors of unfavourable prognosis (P<0. 01). Conclusion BUN/Cr ratio equal or over 15 and USG value over 1. 010 as mark-ers of relative dehydration can predict clinical prognosis of ACI patients after intravenous thrombolysis, and long-term prognosis may be improved through treating the dehydration condition.