急性脑卒中患者 TOAST 分型与慢性肾功能不全的关系

[目的]探讨急性脑卒中患者TOAST分型与慢性肾功能不全（CRI）的关系。[方法]回顾性分析2010年10月至2012年10月本院566例首次入院的急性脑卒中患者的临床资料，比较非CRI患者与合并CRI者在TOAST分型、病灶影像学分布和神经功能缺损程度方面的差异。[结果]566例脑卒中患者中有168例合并CRI者（29．7％）。其中，大动脉闭塞型（LAA ）和心源性栓塞型（CE），在合并CRI组中的比例（42．26％和13．10％）明显高于非CRI患者（22．36％和6．01％）（ P ＜0．05）；小动脉粥样硬化型（SAA）和不明原因型（SUE）在合并CRI患者组中存在比例显著低于非CRI组（ P ＜0．05），差异具有统计学意义；急性脑卒中合并CRI患者非底节区和后循环梗死发生率（42．86％，22．41％）明显高于非 CRI患者（21．87％，11．05％）；底节区梗死率（11．90％）明显低于非CRI患者（36．88％），有显著性差异（ P ＜0．05）；脑卒中合并CRI患者神经功能缺损程度显著低于非CRI患者（ P ＜0．05）。[结论]TOAST 分型可以对急性脑卒中患者是否合并CRI进行初步预判，有助于进行更为深入的诊断及早期干预。

Relationship Between TOAST Classification and Chronic Renal Insufficiency in Patients with A-cute Stroke

[Objective]To explore the relationship between TOAST classification and chronic renal insuffi-ciency（CRI） in patients with acute stroke .[Methods]Clinical data of 566 patients with acute stroke treated in our hospital from Oct .2010 to Oct .2012 were analyzed retrospectively .The difference in TOAST classifica-tion ,distribution of lesions and nerve function defect between non-CRI patients and CRI patients was com-pared .[Results]Of 566 stroke patients ,168 patients were complicated with renal insufficiency （29 .7% ） .The proportion of large arterial occlusion （LAA） patients and cardiogenic embolism （CE） patients in CRI group （42 .26% and 13 .10% ,respectively ） was obviously higher than that in non-CRI group（22 .36% and 6 .01% , respectively）（ P ＆lt;0 .05） ,and the proportion of small arterial atherosclerosis（SAA） patients and patients with unexplained origin（SUE） in CRI group was markedly lower than that in non-CRI group ,and there was signifi-cant difference（ P＆lt;0 .05） .The incidence of infarction at non-bottom section area and the posterior circulation in CRI group（42 .86% and 22 .41% ,respectively） was obviously higher than that in non-CRI group（21 .87%and 11 .05% ,respectively） .The incidence of infarction at bottom section area in CRI group （11 .90% ） was ob-viously lower than that in non-CRI patients（36 .88% ） ,and there was significant difference（ P ＆lt;0 .05） .The degree of neurological deficit in CRI group was significantly lower than that in non-CRI group（ P ＆lt; 0 .05） .[Conclusion] TOAST classification can preliminary predict the patients complicated with or without CRI ,and is helpful for further diagnosis and early intervention .