脑梗死患者轻度肾功能损伤的相关研究

目的 探讨脑梗死患者轻度肾功能损伤的相关危险因素.方法 选择2012年6月至2013年6月收治的脑梗死患者150例,均行磁共振检查,详细记录患者的临床资料,并检测24 h尿微量白蛋白（mALB）,评估肾功能.根据mALB分为肾功能正常组（105例）及轻度肾功能损伤组（45例）.比较两组临床危险因素,并进行多因素回归分析.结果 轻度肾功能损伤组患者年龄大于肾功能正常组（67.04±9.37）岁比（63.01±11.18）岁],高血压、多发性腔隙性脑梗死发生率高于肾功能正常组57.8％（26/45）比33.3％（35/105）、57.8％（26/45）比22.9％（24/105）],脑白质疏松等级高于肾功能正常组,差异均有统计学意义（P＜0.05或＜0.01）.通过二分类的Logistic回归分析发现,高血压（OR=1.041,P=0.045）、脑白质疏松症（OR=2.048,P=0.000）是脑梗死患者轻度肾功能损伤的独立危险因素.结论 脑梗死患者轻度肾功能损伤发生率较高,与高血压及脑白质疏松症密切相关.早期检测脑梗死患者24 h mALB有重要的临床意义.

Research on cerebral infarction patients with mild renal impairment

Objective To investigate the risk factors of mild renal impairment in cerebral infarction patients.Methods One hundred and fifty patients with cerebral infarction were enrolled from June 2012 to June 2013,and all patients received cranial magnetic resonance imaging at the first week.The clinical data of patients were recorded in detail,24 h microalbuminuria （mALB） was detected,renal function was assessed.According to mALB,the patients were divided into normal renal function group （105 cases） and mild renal dysfunction group （45 cases）.Clinical risk factors between 2 groups were compared,and multivariate regression analysis was done.Results Age in mild renal dysfunction group was greater than that in normal renal function group （67.04 ±9.37） years vs.（63.01 ± 11.18） years],the incidence of hypertension and multiple lacunar infarction were higher than those in normal renal function group57.8% （26/45） vs.33.3% （35/105）,57.8% （26/45） vs.22.9% （24/105）],leukoaraiosis grade was higher than that in normal renal function group,there were significant differences （P 〈 0.05 or 〈 0.01）.Logistic regression analysis found that hypertension （OR =1.04 1,P =0.045） and leukoaraiosis （OR =2.048,P =0.000） were independent risk factors for cerebral infarction patients with mild renal impairment.Conclusions The incidence of mild renal impairment is higher in cerebral infarction patients,and is closely related to hypertension and leukoariosis.Early detection of 24 h mALB in cerebral infarction patients has important clinical significance.