小血管病变所致急性腔隙性脑梗死与尿微量白蛋白的相关性研究

目的探讨小血管病变所致的急性腔隙性脑梗死与尿微量白蛋白的相关性。方法回顾性分析2012年11月—2014年4月在中国医科大学附属盛京医院神经内科住院的急性腔隙性脑梗死患者136例的临床资料,并根据颈动脉彩色多普勒超声及头部MR血管成像将其分为小血管病变(CSVD)组(72例)和大血管病变(CLVD)组(64例)。观察并比较两组患者尿微量白蛋白水平。应用SAS 9.1软件进行统计学分析,采用多因素Logistic回归分析方法确定小血管病变所致的急性腔隙性脑梗死的独立危险因素。结果 CSVD组尿微量白蛋白浓度[(22±13)mg/L]明显低于CLVD组[(29±14)mg/L],差异有统计学意义(P0.05);CSVD组与CLVD组患者尿微量白蛋白水平增高情况差异有统计学意义(P0.01),其中CSVD组尿微量白蛋白浓度为10~30mg/L(轻度增高)患者的比例[56.9%(41/72)]较CLVD组[26.6%(17/64)]有增高趋势。Logistic回归分析结果显示,尿微量白蛋白轻度增高与小血管病变所致急性腔隙性脑梗死相关(OR=3.130,95%CI:1.481~6.618,P0.01)。结论尿微量白蛋白轻度增高是小血管病变所致急性腔隙性脑梗死的独立危险因素。

Correlation study of small vessel disease caused acute lacunar infarction and urine microalbumin

Objective To investigate the correlation of small vessel disease（CSVD）caused acute lacunar infarction and urine microalbumin.Methods The clinical data of 136 patients with acute lacunar infarction admitted to the Department of Neurology,Shengjing Hospital of China Medical University from November 2012 to April 2014 were analyzed retrospectively. They were divided into either a CSVD group （n=72）or a cerebral large vessel disease （CLVD）group （n=64）according to their carotid artery color Doppler ultrasound and head magnetic resonance angiography findings. The levels of urinary microalbumin in both groups were observed and compared. SAS 9. 1 software was used to conduct statistic analysis. A Logistic regression analysis was used to determine the independent risk factors for CSVD caused acute lacunarinfarction.Results TheconcentrationofurinemicroalbuminoftheCSVDgroup（22±13mg/L） was significantly lower than （29 ± 14 mg/L）that of the CLVD group. There was significant difference （P〈0.05）. There was significant difference in the increased urine microalbumin levels between the CSVD group and the CLVD group （P〈0. 01）. There was an increasing trend for the proportion of patients with urine microalbumin concentration 10- 〈30 mg/L （56. 9%[41/72]）in the CSVD group compared with the CLVD group （26. 6%[17/64]）. Logistic regression analysis showed that the slightly increased microalbuminuria was associated with CSVD caused acute lacunar infarction （OR,3. 130,95%CI 1. 481-6.618;P〈0.01）.Conclusion The slightly increased microalbuminuria is an independent risk factorfor CSVD caused acute lacunar infarction.